Heal Your Daughter: How Lifestyle Psychiatry Can Save Her from Depression, Cutting, and Suicidal Thoughts

By Cheryl L. Green M.D.

Though adolescent girls have been experiencing high rates of depression for a long time, the recent pandemic has deepened the crisis. Dr. Green has witnessed the rising tide of despair in teen girls both in her own private practice and at the medical university in which she teaches child and adolescent psychiatry. In Heal Your Daughter: How Lifestyle Psychiatry Can Save Her from Depression, Cutting, and Suicidal Thoughts, Green delineates a new branch of psychiatry, Lifestyle Psychiatry, and details how this new field can help parents to help their daughters to heal from depression and related problems. From this book, readers will learn what steps they can take to help their daughters to reshape their daily habits so that, in turn, they can reclaim the foundations of their physical and mental health. Recommendations are offered in six lifestyle domains: nutrition, detoxification, exercise, sleep, emotional connectedness, and stress reduction. Heal Your Daughter has proven to be an important new contribution to our collective understanding and support of today's girls.

• Language: English
• Publisher: BookBaby
• Release date: Feb 21, 2023
• ISBN: 9781667871257

Book preview

BK90071886.jpg

Praise for

HEAL YOUR DAUGHTER

"Cheryl Green possesses academic credentials in literature and medicine, and clinical experience as a child and adolescent psychiatrist. In this lucid and well documented book, she demonstrates how the new field of Lifestyle Psychiatry can help distressed children and families. While the book is specifically addressed to daughters, much of its content is relevant to all families with children. Lifestyle Psychiatry, simply put, is the use of diet, nutrition, sleep, exercise, and emotional hygiene, along with medical treatment as needed, to bring relief to persons with depression and other mental illnesses. Green shows how these interventions can be applied in a fashion that is both organized and naturalistic. Her style is educational but not dogmatic, and she addresses controversial topics in a thoughtful and open fashion.

In each section, the book discusses the particular stresses faced by girls and young women, in a fashion that is authoritative and also revealing. Even if the reader does not accept or follow all of its observations, this book will provoke consideration of perspectives that question common lifestyles and complement current treatments. Perhaps the best part of all is that it will lead families with suffering children to feel less helpless and alone."

-Dr. William M. Klykylo, A.M., M.D., Professor Emeritus of Child and Adolescent Psychiatry, Wright State University Boonshoft School of Medicine

This refreshing and exciting book provides not just tools, but a foundation on which to build our children’s mental health.

-Dr. Grace Matheson, M.D., Clinical Assistant Professor of Psychiatry, Dayton Children’s Hospital, Wright State University School of Medicine

With rates of depression in youth, suicidal ideation, self-harm, and completed suicide at historically high rates, clinicians such as myself across the country are struggling mightily to correct this seemingly ever-increasing trend. Dr. Green has set forth a comprehensive but doable, evidence-based program that offers clinicians, the girls they treat, and their parents the skills to achieve meaningful futures that may have seemed impossible in the past.

-Dr. Rick Bowers, M.D., Medical Director, South Community Behavioral Healthcare, Clinical Professor of Psychiatry, Wright State University School of Medicine

Dr. Green brings an interesting perspective on an important topic affecting our daughters. An essential guide to supporting our girls with key lifestyle practices.

-Dr. Andrew Reza Khavari, M.D., Clinical Assistant Professor of Psychiatry, Dayton Children’s Hospital, Wright State University School of Medicine

This is an amazing guide to helping your daughter. By carefully delineating the various ways of overcoming the obstacles present in our modern society, it will enable both daughters and parents to achieve greatly improved mental and physical health.

-Dr. Uzi Bar-Gadda, Ph.D., former Vice President, Phillips N.V.

Clear and refreshing writing. A nice respite from the absurdity and chaos of the modern world. I think that parents of sons and grandparents should also read this book.

-Dr. Igor Elman, M.D., Research Psychiatrist

Copyright 2022 Cheryl L. Green, M.D.

print ISBN: 978-1-66787-124-0

ebook ISBN: 978-1-66787-125-7

Disclaimer: The contents of this book are for informational purposes only,

and are not a substitute for professional medical advice, diagnosis, or treatment.

Always seek the advice of your primary physician, psychiatrist, or other qualified health care provider regarding any medical or psychiatric condition you might have,

and before you undertake any diet or exercise program or ingest any health-related

supplements. The author is not responsible for any adverse effects resulting

from your use of or your reliance on any information contained in this book.

BookBaby Press

Author website: https://www.cheryllgreenmd.com

United States of America

Table of Contents

Part 1

Nutrition and Detoxification

Chapter 1. Nutrition

Chapter 2. Detoxification

Part 2

Exercise and Sleep

Chapter 3. Exercise

Chapter 4. Sleep

Part 3

Emotional Well Being and the Art of Relaxation

Chapter 5. Emotional Well Being

Chapter 6. The Art of Relaxation

Epilogue: Final Thoughts

Introduction

Most of us who have a daughter have a daughter we want to heal. This book attempts to assist with that desire. It is intended to address your teenage daughter’s mental health needs, whether your daughter is thirteen or nineteen years old, or even older. I hope that the information, exercises, and inspiration provided will empower you to help not only her, but also yourself.

This is not an academic book. This brief book is intended to be a ten-thousand-foot overview of the new field of Lifestyle Psychiatry, as well as a guide to navigating it. It is offered in order to fill an insatiable need that I see in many of the parents of my primarily female patients: I want to help her, but I don’t know how.

Even if you are an academic or professional, what you probably need is not a treatise on the benefits of the Whole Food Plant Based diet, or whatever other lifestyle intervention might be under consideration, but instead a practical, compelling, and comprehensive guide to healing your daughter who – given that you picked up this book – is likely struggling with depression. It is intended to provide a map, a skillset, and a toolkit for you and her together to terraform her psychological landscape into one in which she can grow and flourish.

Importantly, these ideas and information are invitational only. There will be no attempt here to convince nor to persuade either you or your daughter. I will just provide the facts as my training and experience have led me to see them.

An essential fact that needs to be acknowledged here is that, no matter what you do, nor how diligently you do it, nor how cleverly you do it, you actually cannot heal your daughter. She must heal herself if she is to heal at all. But what you can do is to provide a setting, a milieu, an ambiance, in which her self-healing might become easier, and then offer her a companion in the doing. You can help her to heal herself.

The good news is that healing, even from the worst disasters of childhood and early adolescence, is possible. The early traumas that life inflicts need not be managed with ever-escalating doses of psychiatric medications; I believe that they actually can be healed – completely or almost completely healed. There is every reason for hope.

In this chapter, I will describe the problems addressed in this book – depression, cutting, and suicidal thoughts; introduce and describe the new fields of Lifestyle Medicine and Lifestyle Psychiatry; and suggest how the latter can help with the former.

Depression and the Scope of the Problem

The Diagnostic and Statistical Manual of Mental Disorders (DSM),i which is a publication of the American Psychiatric Association, is the book that determines what mental disorders a mental health professional can diagnose, as well as the criteria for those disorders. In DSM, depression is defined as two or more weeks of either sad feelings or the inability to experience pleasure, in conjunction with five or more problematic changes in the following areas: sleep, interest and motivation, guilt, energy, concentration, appetite, the rate of mental or physical activity, and/or suicidal thoughts. For her to meet the criteria for depression, her difficulties in functioning have to impact two or more domains, such as her family relationships, her academic performance, her friendships, and/or her extracurricular activities. Severe depression is defined as this, in combination with either self-harm, such as cutting, or suicidal thoughts.

The DSM offers descriptions of mental states. The descriptions don’t say anything about the etiology – the root causes – of those mental states. For depression, there may be different root causes. For example, depression could be situational, having to do with stress or trauma. Or it could be based in genetics, biology, nutritional deficiencies, psychological factors, or other factors.

Whatever the reason or reasons behind it, depression is very common. I want to start with the scope of the problem, not to depress either of you further, but to make you realize that your daughter is not alone in her depression, in her desire to self-injure, nor in her suicidal thoughts. Depression and suicide attempts, let alone suicidal thoughts, are at an all-time high in the United States and around the world.

The Center for Disease Control and Prevention (CDC) reports that depression and suicidal thoughts are indeed an important concern. CDC cites dataii on adolescents aged 12-17 years of age from the year 2017-2018, indicating that during that time period:

15.1% had a major depressive episodeiii

36.7% had persistent feelings of sadness or hopelessnessiv

18.8% seriously considered attempting suicidev

15.7% made a suicide planvi

8.9% attempted suicidevii

2.5% made a suicide attempt requiring medical treatmentviii

CDC also cites National Syndromic Surveillance Program dataix from the period January 2019 through May 2021, indicating that – based on data from 71% of U.S. Emergency Departments (EDs) in 49 states and the District of Columbia – ED visits for suspected suicide attempts among adolescents aged 12-17 increased dramatically during the recent pandemic. ED visits for suspected suicide attempts were:

22.3% higher during the summer of 2020 than during summer of 2019x

39.1% higher during the winter of 2021 than during winter of 2019xi

The increase was even more pronounced in teen girls. The rate of teen girls visiting an ED for a suspected suicide attempt was:

26.2% higher during the summer of 2020 than during summer of 2019xii

50.6% higher during the winter of 2021 than during winter of 2019xiii

In contrast, the number of ED visits for suspected suicide attempts remained stable among same-age adolescent boys.

These data show that an alarming percent of teens today are struggling with depression and suicidal thoughts, and that rates increased dramatically – at least for teen girls – during the recent pandemic. When society itself is experiencing a tidal wave of socioeconomic problems – disease, isolation, ideological confusion, poverty, crime, or whatever other stressor you can name – most of that society’s members will eventually become engulfed in that wave, one way or another. And this is the situation our daughters face.

Cutting and the Scope of the Problem

Non-suicidal self-injury (NSSI), usually in the form of cutting, is widespread among adolescents, with lifetime prevalence rates between 17 and 60% in recent studies.xiv There are relatively few studies regarding effective psychotherapeutic treatments for NSSI in adolescence. However, cutting is widely regarded as a coping mechanism for depression, anxiety, stress, poor self-esteem, and other emotions. Cutting is especially common among teens who have experienced trauma, particularly sexual trauma. The cutting itself is usually superficial and does not in itself lead to death. However, it has been found that those who do die by suicide are about ten times more likely to have been cutters than those equally depressed who were not cutters. Thus, cutting is thought to be a rehearsal, a training of the brain to self-injure when under duress. This can be quite a dangerous program to have running in your daughter’s brain. It is a dangerous habit to have acquired, particularly when stress becomes extreme, as it tends to do.

Suicidal Thoughts and the Scope of the Problem

The shocking thing is how common suicidal thoughts are in high-school-aged youth today. Even before the pandemic, over half of high school teens reported that they had experienced suicidal thoughts within the previous year. And as we just saw, rates of actual suicide attempts dramatically increased during the recent pandemic.

Of note, though, relatively few girl teens who attempt suicide succeed. Only a small proportion, less than one percent, actually die after such attempts. What this means is that – with the right treatments – most teen girls with suicidal thoughts can be helped. Evidence-based strategies include preventing and mitigating adverse childhood experiences (for example, abuse), strengthening economic supports for families, limiting access to lethal means (for example, safe storage of medications and weapons), improving access to evidence-based care, improving girls’ social connectedness, improving their coping skills, and so on.xv

Defining Lifestyle Medicine

There exists a new field of medicine called Lifestyle Medicine. Founded in 2017 as a board-certified field of medicine, Lifestyle Medicine consists of a set of guidelines for how your daughter can live so that she can enjoy optimal physical and mental health.

Two alternative definitions of this field have been proposed and accepted by the American Academy of Lifestyle Medicine.

The first definition focuses on the creation of vibrant health. Lifestyle Medicine is: "The evidence-based practice of helping individuals and families to adopt and sustain healthy behaviors that affect health and quality of life . . ."xvi

The second definition focuses on the reversal of disease: "Alternatively, Lifestyle Medicine is the use of therapeutic lifestyle changes to treat, prevent, and reverse disease."xvii

Regardless of whether this new field be understood as one that attempts to create health, or whether as one that attempts to treat and reverse diseases, Lifestyle Medicine is fundamentally not about taking pills. It is about rearranging one’s life so that, simultaneously, diseases are reversed and good health is restored.

This, truly, is a revolution in medicine, representing a tectonic change.

The basic guidelines provided in the field of Lifestyle Medicine are all supported by scientific studies that demonstrate their validity. Guidelines are offered in six domains: nutrition, exercise, sleep, stress reduction, emotional and social connectedness (or wellness), and detoxification from substances that have been shown to be harmful to health. These guidelines are simple, yet so powerful. As is true for every branch of medicine, the recommendations evolve and are refined each year as new scientific studies become available.

The most comprehensive codification of these guidelines to date is probably Lifestyle Medicine, Third Edition, edited by James M. Rippe, M.D. in 2019.xviii

Defining Lifestyle Psychiatry

There exists an even newer subfield of medicine called Lifestyle Psychiatry. This field consists of the body of evidence from Lifestyle Medicine that pertains to mental health. Specifically, it is the application of that evidence toward the goal of achieving optimal mental health. But perhaps not surprisingly, nearly every guideline that improves the health of the body also improves