I was once told a story of a 5-year old girl who was asked by her parents if she knew what a diet was. She initially said no, and skipped out of the room, before returning to say "Is a diet when you don't eat very much so you don't get fat - eww?" Her parents were aghast at her knowledge and wondered where she got this information about dieting and her perception of being fat as something to avoid. Unfortunately, it is my observation that our culture bombards us with dangerous messages, about extreme thinness and dieting practices, exalting a thin physique after a commercial for a super-sized fast food meal, and about the purported attainability of a thin body for all women who have enough "willpower."

In this culture of conflicting and exploitative messages, one question that arises is whether dieting is actually problematic? The short answer is YES! The long answer is that among college-aged women who have dieted (study published in 2002 in the Journal of Psychosomatic Research), the more frequently these women dieted, the greater likelihood that they reported problems such as more frequent depression symptoms, lower self-esteem, greater obsessiveness and preoccupation with exercise, greater body dissatisfaction, and more frequent eating disorder behaviors.

A lifestyle approach healthier than dieting is to adopt a moderated meal plan, incorporating regular eating of a variety of foods from all food groups, and to implement a regular exercise regimen that is enjoyable and not extreme. Avoid fad and highly restrictive diets, and certainly do not encourage young individuals to diet particularly during growth spurts. The quality of life results will come, in time, and hopefully bring you significant lifestyle benefits.

Youth today have many options for procuring health care information. In addition to physicians and nurses, parents and friends, they also have access to a wealth of information on the internet. In 2001, we surveyed a nationally representative sample of 5th through 12th grade youth in the US to understand where they were obtaining their health care information. Over half of boys and girls said that they turn to their parents and/or a doctor or other health professional for health care information. Yet approximately 25-33% of youth also noted gleaning health care information from potentially unreliable sources, such as magazines, television shows, newspapers and the Internet. Of further concern is that 10% of youth said they did not know where to get health care information.

The survey also asked if there were topics that adolescents would be too embarrassed, afraid or uncomfortable to discuss with their health care provider. Over one-third of boys and girls reported that they would be too embarrassed, afraid or uncomfortable talking about physical or sexual abuse, menstruation (girls only), body changes and sexuality.

The health care of youth is too incredibly important for these issues not to be discussed, or for teens to turn to unreliable sources for their health care information. I believe this means that we need to be better advocates for adolescent health care, asking youth appropriate questions and providing them confidential opportunities to discuss sensitive topics. This can be accomplished by health care professionals and others by establishing a good rapport, taking time out to listen to teens, assuring and maintaining confidentiality, and helping them access appropriate information as needed.

There's an impatience in our lives. We're technologically connected at the hip, (blue)tooth and thumbs. We can update our status on Facebook to let our friends know instantly what we are doing. So where's the pixie dust and magic wand to make mental health issues improve instantaneously? In the words of the Beatles, so you say you want a revolution?

Changes in mental health typically do not occur overnight. I suppose there are some exceptions, but true change is more likely to be evolutionary than revolutionary. That means that we can benefit from being patient, and deliberate in our pursuit of mental health change. Perhaps an applicable analogy is that we are our best guinea pigs for our own research - we try something new (like getting more sleep at night, taking a mindful walk on a daily basis, or opening up to a trusted person) and *observe* over time if that helps. If it does, then keep on doing it. If it doesn't, then we try something else new that might be helpful. The evolution of the improved, happier you will emerge in time, yet it may emerge with a timeline that is longer than that which you wanted. Be patient, as only when we continue to work on building our foundation and working daily on those practices that enhance our mental health do we reap the long-term benefits.