Is It An Eating Disorder Or Is It OCD?
Reading Time: 24 minutes
Is your child a “picky eater?” Is he sensitive to the texture of food?
Are you concerned that your child may have an eating disorder?
Have you ever wondered if your child’s eating habits are the result of an eating disorder or OCD?
If any of these thoughts or questions have surfaced for you in the past, you don’t want to miss out on this blog!
I sat down to have a very candid discussion with mental health trailblazer Dr. Roseann Capanna-Hodge about this very topic.
Her work has helped thousands reverse the most challenging conditions using natural, safe and PROVEN holistic therapies. The last time we talked we had a great conversation about stress and anxiety in kids, warning signs, and what parents can do to help. So if you happened to miss it, I encourage you to check it out here.
But this week, we dove into a slightly different topic. Though there may be some overlap, we discussed another common issue in kids - eatings disorders or restrictive eating - and more specifically, how to tell if a child has an eating disorder or if they may be dealing with something else - like OCD.
So sit back and enjoy the conversation I had with Dr. Roseann!
An Interview with Dr. Roseann
Me: I am very excited to welcome back a special guest - Dr. Roseann Capanna-Hodge. She is a mental health trailblazer on a mission to change the way we view and treat mental health
Dr. Roseann: Yeah, I’m so glad we’re having this conversation. I do a lot of work with kids, teenagers, and young adults that have Obsessive Compulsive Disorder - and it is misunderstood. Many times they are misdiagnosed as having an eating disorder if their OCD interferes with their food. Our goal is to help people get the right diagnosis - because without it you cannot get the right treatment. Eating disorders are on the rise during this time, as all clinical issues are during this pandemic.
Me: Yes, and thanks again so very much for being here. You mentioned that rates are definitely on the rise - is that common among everything? Eating disorders? OCD? Anxiety? Depression?
Dr. Roseann: Yeah. We know through survey research, not just throughout the United States, but other countries as well, that anxiety, depression, and suicidal thoughts are all on the rise during the pandemic. And if somebody in your house, like an immediate family member, has COVID, then your teen or young adult has a 50% chance of having clinical depression. This is kind of shocking, but kind of not because there’s a lot of stress associated with that.
But things like eating disorders and OCD we know have risen during the pandemic. It also isn’t surprising that OCD has risen because the nexus of OCD is often anxiety. Though it’s not 100%, when we look back on the clinical history of someone with OCD, we see generalized anxiety. OCD is a way of coping with a stressor.
“OCD is a way of coping with a stressor.”
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People with OCD are trying to find, what they think, is a way of calming it down. You and I might do breath work or go for a walk. We have healthy and unhealthy ways of coping with stressors that produce straight stress or high levels of anxiety.
With them, it sort of glitches in the brain. If the brain says - Oh, if I’m afraid it’s going to rain today, if I ask my mom - is it going to rain and she says - no, it’s going to be great day - neurologically, what happens is that puts the fire out and calms things down.
That’s called a negative reinforcement cycle and the person is more likely to repeat the behaviour over and over. Parents inadvertently accommodate the behaviour and they don’t even know it. The next thing you know, the kid is on fire.
During this time, what have we all been worrying about? Getting sick. For some people with OCD, they turned it into an obsession about getting sick or compulsive behaviours related to that. That anxiety may never have even shown up as being worried about germs. That’s another misconception about OCD - that they're specific about things like hand washing.
I’m not surprised, as a clinician, that we’re seeing a rise in everything, including OCD and eating disorders.
Me: Right. I know you mentioned some different components of OCD. But is there a generalized definition? If someone were to ask if they weren’t familiar with it, what would you say is OCD?
Dr. Roseann: Yeah. It is when you have obsessive thinking or compulsive behaviours or rituals around one or more areas or things and you are spending more than an hour a day having obsessive thinking or compulsive behaviours.
That is what’s different. As you know, people can say - ahhh… I have OCD, I like to keep things clean. But that’s not OCD. However, if you’re spending an hour a day having obsessive worries about cleaning, then we’ve got a problem. Another thing to consider is if that behaviour is to avoid something.
Take the example I used of the storm - this is a true story from about 15 years ago. I had a kid who became afraid of storms and started to obsess and worry. All of his drawings were about storms. He needed obsessive reassurance, more than an hour a day, that it wasn’t going to storm. And as I said, his parents were, as we say, “feeding the barking dog” - feeding OCD by answering his questions.
It would be the most beautiful day in the world without a cloud in the sky and he’d ask - is it going to storm today? His parents would day - we just checked the weather, remember? Then he’d ask again - is it going to storm today?
What happens, neurologically, is that the brain says - ok, I have a worry. It’s spiking… it’s spiking… it’s spiking… let me ask a question. And you get an immediate down as the worry decreases. But what happens in a negative reinforcement cycle, is every time the parent accommodates it, you move the baseline up. So instead of it going down and reduce the chances you’ll repeat the behaviour, you’re actually increasing it every time.
OCD is so insidious. The other part about OCD - you asked about a basic definition - well for pretty much most people it starts with obsessive thinking. It’s a very internal thing. You can be very surprised that some people can be so functional yet have raging obsessive thinking that really interferes with their attention and their relationships.
Like any clinical disorder, these things have to get in the way of your daily functioning. So if these things just pop up every once in a while, like you had to go back and make sure you turned the coffee pot off, that’s not OCD. But if you had to go back 7 times and you had a whole ritual around it - and you do it 7 times, and it’s every day - then we’ve got a problem.
Me: Good to know. I didn’t know that about the hour or more a day spending time on it - that’s very interesting. And what about anxiety? Is anxiety a cornerstone of OCD?
Dr. Roseann: We can get into the different sources of what happens and why people have OCD, because big Pharma has convinced everybody that everything is genetic. But it’s not. I’m here to tell you that’s the least common reason of mental heath problems.
Anxiety is often a cornerstone. So if you think about OCD as anxiety - with anxiety we have healthy ways and unhealthy ways of dealing with it.
What are some unhealthy ways people cope with stress? Drinking and drugs. Emotional eating. Irritable behaviours. Violence. Avoidance - doing nothing. Being horrible to yourself - inner terrible thoughts. I think most people are horrible to themselves, and say terrible limiting things to themselves all the time. But what happens with OCD is different.
I know when I’m under stress, I say - cut it out, just stop, and breathe. I know I’m going to feel better - that’s a go-to for me. And I recognize this at a deeply subconscious level.
Your subconscious is in charge 95-99.5% of the time, meaning that it’s leading your decision making. Most of the time you are not conscious. It’s your subconscious that’s helping you inform those 34,000 decisions you’re making every day.
What happens with anxiety is you think - oh, I breathe then I feel better, so, stop and let me breathe. Then with OCD, at that negative reinforcement cycle that we’ve talked about, it’s like - oh, if I ask my mom this question… if I tap 7 times… if I count backwards… if I do this… if I do that… if I wash my hands… your subconscious recognizes there’s a relief.
When I talk about behaviours, I talk about behaviours of the subconscious.
One of the top questions people ask me on every clinical issue is - is my kid doing this on purpose? Do you feel that way, too?
Me: Yeah.
Dr. Roseann: Yeah. Ok so that doesn’t mean those little snickers are not doing something every once in a while, I’m not saying that. But nobody wants to be anxious. Nobody wants to act out aggressively. Nobody wants to do theses things. It becomes the nervous system’s way of responding to something that’s very uncomfortable. So when you start thinking about that and behaviours - that’s why people are so successful when they work with me because I say - no, you have ADD all wrong. No, you have eating disorders all wrong. Let’s think about the nervous system and let’s think about it from neuroscience and attacking it.
So when we see anxiety - is anxiety the nexus of OCD? Yes - most of the time. Does it mean that you 100% have it? No. Does it mean that everyone who has anxiety has OCD? Absolutely not. But it is a cornerstone.
The problem is they (anxiety and OCD) cannot be treated the same. They have different ways of being treated. OCD, because of the negative reinforcement cycle, ignites at a deeply neurological level quicker. You can switch really quickly.
So when you asked during this pandemic, did I actually see an increase? I saw that for sure, but what I saw was people who had lower levels of OCD… what does that mean? That it wasn’t disrupting their life as much… go from functional OCD to complete shut-down OCD.
I have so many parents calling me right now saying their kid’s OCD is so bad they are refusing to go to school, they stopped eating - really extreme things that went from 0 to 60 when a lot of additional stressors were put on them.
They didn’t have a healthy toolkit. We know that one of the biggest factors in kids mental health, going back to the other episode, is coping skills and resilience. And that is key to wether or not its eating disorders, restrictive eating, OCD - that is a key neuroprotective factor - to protect you from mental health, but it is the way to unwind mental health issues, as well.
Me: How do you suggest they often develop? How would someone go from starting off with a little bit of anxiety or having small compulsions to becoming considered to have OCD?
Dr. Roseann: When it comes to how OCD develops, we have different lines to what’s the root cause - what is the actual root cause. You have genetics - but I’m going to flip your genetic notions on your head, too because when we talk about genetics, we only talk about it as neurotransmitters - again because that’s what Pharma wants us to believe. But the other side of genetics is the people around you. What are they showing you at a subconscious level?
So if your aunt has OCD and sh’e around you all the time - or your mom, your dad, your grandparent - what are they showing you in how they cope with every day stressors? How does that anxiety, depression, OCD - how does it show up? That is how you need to think about genetics - the behavioural part of genetics.
Kids learn by watching. That’s how they learn. Your mouth could be moving and you could be saying - I’m not stressed-out. But if you look like a hot mess, you’re biting your nails off, you’re sweating, you lost 30 pounds and you’re telling your kid everything is great - that is not what you’re showing them. Not to make you feel bad - but I look at everything as an opportunity to get better. Right, Kelly?
Me: Absolutely. Right.
Dr. Roseann: So we have genetics, we have what you are learning from people around you, and how you are coping with stress. Because you can have anxiety or depression and have amazing resources, then you’re showing your kids that. That is what they’re going to learn.
And then we have infection and toxin triggers for OCD and even eating disorders because it turns into restrictive eating. A large, increasing amount of kids I work with, including young adults and teens, have PANS and PANDAS or something called Autoimmune Encephalitis. Super quick, that’s an infection or toxic trigger that causes a misdirected immune response. The body starts attacking itself. That causes massive inflammation and that inflammation produces neuropsychiatric characteristics. Inflammation causing mental health issues goes back decades. We have postmortem research on people with autism, that 72% of people with autism have inflammation. That’s no surprise for me and my colleagues who work with people with autism.
Me: Not at all.
Dr. Roseann: Right? So we have physical sources of OCD that do that. And I get to do this beautiful thing called a QEG brain map that gives us a visual representation of the health of the brain - you’re able to see what type of phenotype you have. Because a person who has an infectious disease is going to respond differently and need different types of treatment. We can’t ignore if there’s Strep or tic-borne illness, or mold driving that behaviour. We can’t just say - oh yeah, put him on a psych bed.
And just so everybody knows, those treatments are very specific ways to dismantle OCD. What the research says about all mental health issues and what we do with the brain behaviour reset method is calm down the nervous system then come in with new learning. In the case of OCD we use tools like biofeedback, neurofeedback, different things like that, then we use the best, most research-supported type of therapy which is Exposure and Response Prevention (ERP).
All Exposure and Response Prevention for OCD is - the gist of it is this… it teaches you how to talk back to your OCD. Go on to IOCDF and you can find a provider or you can go to Anxiety and Depression Association of America and find a provider. Why? Because they help you identify the exposures, lots of psycho-education for the child and the family - it’s the same thing for an adult. Then you learn, in a safe, therapeutic environment, how to be exposed to these things that you have developed. You feel uncomfortable then you exhibit an obsessive or compulsive behaviour. So it’s teaching you that if you don’t ask your mom if it’s going to rain, guess what? Something bad isn’t going to happen. Because that’s what they are avoiding - they think something bad is going to happen.
When they learn that, the brain says - oh, nothing bad happened… I don’t have to ask my mom 6 times. And they start to unwind the behaviours. Its very methodical, super effective, very evidence-based. And we don’t have great research about psych meds for OCD because its so deeply neurologically behavioural. And again, not on purpose, but the way the body responds - the way that person responds.
I think most people have never heard this. I’ve met people that have gone to 10 therapists for OCD and they say - this is mind-blowing… I understand this and now I understand why I have to do this.
People will tell others they need ERP but the people will have no idea why. They say - I’m just here because somebody told me I have to come here.
And it’s really important, no matter what your mental health issue is, that you understand the why behind it. You have to participate in therapy. It doesn’t happen if you go one time then wave a magic wand. You have to do some work to address the neurological components to get it to stick.
Me: What’s the typical time frame? How long would it take for someone to go through those therapies and start showing improvement.
Dr. Roseann: Everyone is different - there is a bio-individual component. When we combine things like neurofeedback and biofeedback with the ERP - and we don’t work with people on ERP any more unless you’re doing PEMF or neurofeedback or biofeedback because it takes forever. And people are struggling. So when they come to us, that’s our methodology - that’s what we do. People will start to show differences in a matter of a few sessions. Are they lasting? Do you get to walk away? No! You have to reprogram and put in good things.
I find that most people are getting either full symptom resolution or in a completely normal manageable range within 4-6 months. Most people can certainly wrap things up around the 6 month mark. We’ve had people with a 10 year history of serious OCD, and they may be only 16 years old. They’ve gone to 5 or more therapists, they have PANS/PANDAS - it’s really supporting them through what all the underlying issues are. If there’s a genetic mutation component or if there is an infectious disease component, you’ve got to do the root cause work - you can’t just leave an infectious disease sitting there.
But most people are pretty amazed at how far they can get. We really believe that within 3 months, most people should be significantly better. Does that mean they stop at that point? Absolutely not. But we’re using science to hack into the nervous system to make people feel better. And honestly, the number one determining factor, of course if the kid is cooperative - but they almost always are, is the parents being consistent.
It is the number one barrier to a child, particularly with OCD, being successful. Because you have to change the way you’re acting. You have to stop accommodating.
I remember one time I had a mom who got so upset with me - how dare you tell me that I am causing this! I said - I don’t know what you’re talking about - I never told you you were causing this… I’m telling you that you are inadvertently feeding the OCD. You're not causing it - your kid developed this and you’re all acting in a way that you’re not teaching her coping skills, so let’s switch your language. This is exactly what the research tells us, and she’ll improve.
They were just unwilling to do that. OCD can hijack a family like I’ve never seen before in my life.
Me: Interesting. And the other component to this is the eating disorders - restrictive eating. How does restrictive eating and OCD come into the picture?
Dr. Roseann: Yeah, right. There are eating disorders where you’re binge eating. There’s eating disorders like anorexia where you stop eating. And the root causes of those can be very different.
We often talk in the world of mental health with eating disorders, that typically there’s a family systems issue with eating disorders. There might be a particularly controlling parent. One of the reasons why people develop eating disorders is that they are trying to control something. So they learn to control their food. And that’s where they put the control. It might show up very differently in a different area for someone else. But a lot of times we know the psychology behind it is they’re looking for control.
We also have many traumatized folks who will develop eating disorders - somebody who’s been sexually or physically abused, or even neglected. That can be a source. And then there’s this group of people who start out restricting their eating. Why do people start off restricting their eating? One of the biggest reasons is sensory processing - that the food doesn’t feel right to them. That the texture is bothering them. The temperature is bothering them. And these people tend to have a primary clinical condition like autism, sensory processing disorder, PANS/PANDAS, or ADD. Then they struggle.
So we have these restrictive eaters - there’s this group of people with ARFID (Avoidant Restrictive Food Intake Disorder), which can then morph into an eating disorder. Or you have a group of people with OCD who have obsessions and compulsions around food. Many of my people with OCD avoid food for two reasons.
One - it’s germ phobia. They think there are germs in the food. They think people have spat in the food or there is some type of contamination with food. So they start restricting their eating based on OCD.
You can understand as a clinician - I view myself as a detective. What’s going on behind it? What started it? How did we get there? A lot of times, mental health is a dinosaur - it’s a lot of guessing, which is why I love my brain maps and brain checks because we have data. We can look at different regions of the brain and it can give us some indicators. A person with an eating disorder’s brain looks different from an OCD brain, by the way. Then you dig deeper. You have the data then you dig deeper.
The other part about restrictive eating is that there is a whole group of people with OCD that have a fear of throwing up and vomiting. So they start restricting their eating because they are afraid of vomiting.
I’ve had so many people who were diagnosed with an eating disorder when it was clearly OCD. But nobody asked the right questions. So you really have to know and look for clues, like did this person have a lot of anxiety? Plus someone with an eating disorder is very likely to have experienced some kind of big event like a trauma or a lot of conflict with parents.
Now somebody with OCD is also going to have conflict with parents because the kid is going to try to dictate everything based on wanting their obsessions and compulsions met. But was it always like that?
So it doesn’t mean you always have an eating disorder if you have a trauma in your background but it is a red flag. So you want to explore that. And you can restrict your food so much that you technically meet the criteria for an eating disorder.
“Eating disorders are very scary. ”
Eating disorders are very scary. They have the highest mortality rate in mental health. About 20% of people with an eating disorder will die due to just restricting their eating or having cardiac problems.
So we want people to eat. And the focus on eating disorders is calorie intake. But this is not how you get somebody with OCD to eat. Unfortunately, I’ve had a lot of my PANS, PANDAS, and OCD people forced into eating disorder treatment centres and it was a nightmare.
Me: I’m sure that adds a whole other level of frustration, anxiety, and problems.
Dr. Roseann: Yeah. And just a sense of hopelessness for the kids and the families. I am privileged that I am often the last place someone has to go. But I am pissed off that they have to go to all these other places before they get to me. Because it’s really unnecessary and a lot of ignorance. Yeah, I’m smart, but so are a lot of people - people with advanced degrees. It’s really not taking a common-sense approach to mental health… What is going on? What are the simple questions we have to ask?
I’ve done thousands of intakes - I can’t even begin to say how many I’ve done. That’s my primary role of what I do; when somebody comes to Dr. Roseann, I do the intakes. You get me. And I’m not willing to give that up!
Everybody asks - can’t someone else do that? And they could, but I love it because I like to put the pieces together myself.
These are things that people can learn - if you know that you’ll be dealing with eating disorders, you’d better know PANS and PANDAS because there’s a crossover.
Just like depression. I specialized in ADD right out of the gate. When you specialize in ADD, you’d better learn every disorder there is. So that’s how I got into learning so much about so many different things. Everybody’s attention is impaired when they have a mental health issue.
So different sources require different treatments, and that’s the way to reverse and treat these issues. It really becomes a systematic and logical way to approach things.
The other part of this is having the right tools, like ERP - Exposure and Response Prevention. There’s not many of us in the United States who do it. There’re there, you just have to find them and you may have to wait for them. But don’t go to a therapist who says - yeah, I specialize in anxiety or OCD - if they don’t do ERP. You’re literally wasting - forget about money, everyone always goes to money - but you are wasting your hope. When you waste your hope, it’s a lot harder to climb out of that hole!
Me: That’s a great way of looking at it. You find the right person who can give you the right help and ask the right questions who knows what they are doing and who definitely has a big toolkit.
Dr. Roseann: Absolutely.
Me: I also deal with people who have eating disorders and what’s interesting to me is they often call themselves a picky eater. If someone is a picky eater, is that kind of a red flag that might lead to more restrictive eating?
Dr. Roseann: Well, I’m always so logical - what’s underneath that? One way for a person with an eating disorder to mask their eating disorder, because they’re so clever, that they know how to divert attention. Because “picky eating” has become so common.
I posted yesterday on my (IG) Stories my son’s breakfast. Now, my kids are amazing eaters - they never had access to anything that wasn’t amazing! My 11-year old eats dinner for breakfast - that’s what he likes. So he had steak and on the other side of the plate was hearts of palm. Do you know how many direct messages that I got? I can’t even count. They all wanted to know, “What’s the thing on the left?” - they all didn’t know what it was.
I’m not discounting picky eaters, because let me tell you, I get it! But we have to think about it as a sensory component. So when someone comes to me as an eating disorder person and say, “I’m a picky eater,” I say - tell me about that, when did that start for you? And I’d want to hear - ohh, a tomato just made me want to vomit. I want to hear those things - I can’t have this, I don’t like that, I need everything to be bland. I want to hear those sensory words versus - I just don’t like a lot of things. That sounds masking to me.
Then I’d want to ask - what are your concerns that make it picky? I ask people that. One girl said, “I’m worried that someone is spitting in my food.” Boom. There you’ve heard some obsessive thing that’s not rational. When we look at OCD and anxiety, even though anxiety can be a nexus, a lot of times anxiety has a rooting that makes sense.
I remember I had a kid who developed OCD. It started with anxiety. He had gotten a terrible splinter, so bad he had to have surgery. It was terrible. So then he had all these worries - he was a worrier kind of kid to begin with, so it was already starting to crack. He didn’t want to try new things.
What are signs of worriers? Not wanting to try new things, hiding next to his mom at the playground, being slow to warm, having lots of bellyaches, having difficulty separating - a lot of somatic kind of complaints. What happened was he started to worry over and over about splinters, but there was no rational. He could be in a place where there was not a piece of wood in sight and he thought he was getting a splinter.
The difference between OCD and anxiety is, anxiety has a bit of realism in it that can morph into an OCD. And with OCD, it’s a lot of very dark things, it can be sexual, it can be religious, it can be thoughts of harming other people or themselves. They don't believe they’re going to do it, but they’re worried they’re going to do it. Do you see the difference?
They’re not thinking they’re going to harm someone - they’re worried that they’re going to harm someone - with no intention behind it. And this goes on all the time. It’s another reason why people get committed to psychiatric hospitals. But no one checks under the hood and asks them that.
So OCD morphs into something that doesn’t make any sense. It can then become many things and can wax and wane into different areas. And most people are pretty functional with OCD. You can be functional with an eating disorder for a long time, too, if you’re really good at hiding it.
Me: Yeah. So what warning signs should parents and caregivers look out for? When should they start to worry?
Dr. Roseann: Let’s start with anxiety - you can go back to the last podcast for more. There are lots of somatic issues. Does your kid seem withdrawn? An internalizer? An externalizer? Angry? Irritated? Or any where in between?
Number one, do not use your kid’s grades as a benchmark. I’ve had people be straight-A students and kill themselves. It happens every day in America and across the world. Get rid of that notion.
OCD - what are some characteristics? I had someone recently come in - I’m going to share their story because it’s the same story I’ve heard dozens and dozens of times. The mom came in and said - his OCD just started all of a sudden. I’ve heard that one before, so I asked what’s going on. I knew the answer - it was a return to school. School had been virtual for the last year and half.
That’s been a real trigger for anxiety, depression, and a lot of things with the kids I’ve been working with because some people, as much as their parent hated schooling them from home, it could have been an amazing experience for some of these kids. Some of my kids loved having their own ability to pace themselves, not having social interactions, or worrying about germs, whatever it was - they could be in control.
So then I said - lets back it up. When he was little, did he ever have anxiety?
Mom said no but dad said - maybe a little. OK. So you start getting different view points. What came out was that it over the last three years he had OCD - at a pretty significant level. But because of the way the family dynamics were, they didn’t realize they are accommodating it. What were the signs?
One of the biggest signs of OCD is a need for reassuring questions.
I’m going to give you an example. I have a kid at home who has a need for reassurance. One question. You reassure him. He’s fine. He’s a kid that needs to know about things in advance. This is his personality and makeup - and very much like my mother! There is a crossover in the two of them in some really beautiful ways - thank god he only picked up her good stuff! He’s got a crazy memory for everything. I had to tell his new teacher - listen this is a kid who’s gnoing to say, “Mrs. Sankie, don’t forget, we’re on chapter two. We’ve got to finish it, we’re on page 37, and we left off here.” He’s going to be that kid. But don’t be insulted he loves it and will be very polite about it. He’s not a know-it-all, he’s a helper.
Great example - today was off-routine. I said - hey, John-Carlo, here’s a tip… right behind the school before you hop on the highway and drive an hour to go get your brother - he said, “45 minutes.” Right - 45 minutes to go get your brother. Stop and there’s a vegan, gluten-free, dairy-free place that has acia bowls and shakes. He said - oh that sounds really good. Then he said, are you going to tell dad or am I going to tell dad? I said - I’ll tell dad, you know haw dad is.
He said - yeah ok. And he let it go. It was over and done. But someone with OCD might come back to me. He might text me, he might come back to me the whole way to school in the car asking - can we call dad now? Did you talk to dad yet? Do you think dad understood where it was? Do you need to send him a picture? What time do you think we’ll get there? What should I get there? And so on.
Anybody who has OCD, anyone who has a kid with OCD, or lives with someone with OCD - you end up shaking your head. So a high need for reassurance is one of the biggest signs. Another is the need for bedtime rituals. They may insist on a certain kind of ritual, particularly at bedtime because anxiety can really spike before bed. So you want to look for that. You also want to look for rituals in other areas.
So, back to my example - the family that said no, there was no OCD, well they had so many rituals they were doing over the last 3 years. It was like I was putting a black light on it - you know like when someone says, “There wasn’t a murder here…” and you shine the black light on the scene and puff - blood splatter everywhere! Now that may be the wrong analogy, but it is pretty funny.
All of a sudden she got it. She didn’t understand that there were rituals and other signs going on.
You also want to look for somatic issues. That’s going to exist in both anxiety and OCD. With OCD, your kid could also have observable things - like they might be counting under their breath or you see they can only leave the house when the clock is on a 7, or other kinds of things that may just start clicking in your head. But remember, they are still functional. But again, OCD is where they are very obsessive in their thinking and have intrusive thoughts. There isn’t anyone with OCD that doesn’t have intrusive thoughts. And let me tell you, when you meet with a therapist that does ERP and they open the door to intrusive thoughts, parents are shocked at how much is running all the time in their kid's head about these different thoughts.
So look for signs of adherence to rituals and excessive questioning. These two things in particular, are really common and often missed.
Me: Okay. And is there anything else you’d like people to know about OCD or restrictive eating?
Dr. Roseann: Yeah - the longer it goes untreated, the more the habit forms. It’s a habit - a subconscious behavioural habit. It is one of the most treatment-resistant conditions. Before I started doing Exposure and Response Prevention, I had better luck treating a heroine addict. Because the behaviours are deeply ingrained at the neurological level and the families participate in it, not knowing that they are actually feeding that OCD.
The best part about it now, is it’s one the best, most effectively treated conditions using the combination of resetting the nervous system and coming in with new learning. And it really has to be Exposure and Response Prevention. It really does.
I know people will say - you do starlight CBT. No - not with what we do and our people. The families really need to understand it and have to be willing to make these changes. It’s about shifting what you are doing and shifting your efforts that are literally causing you to spin your wheels and stay stuck, to changing your behaviours so your kid is not so anxious. It is an awful awful thing when you see an OCD brain, or anybody with anxiety or panic attacks - the level of activation in their brain is so high, it’s almost impossible for them to think.
If you see it, address it - just go and do the work with somebody who is highly trained. It will save you months, or even years, of heartache.
Me: That is great advice. And do you have this type of information in your latest book?
Dr. Roseann: I totally have it in my book “It’s Gonna Be Okay” and I have a lot of amazing blogs about OCD on my website drroseann.com. I want people to be educated. And like I said, you can find a provider on IOCDF or Anxiety and Depression Association of America - make sure you click ERP.
Me: Perfect. Thank you so much again for your time and expertise. I really appreciate it. It’s fascinating to listen to you talk, to hear all the stories about the people you have impacted. They would not have received the same kind of life-changing, transformational support had they gone anywhere else. That’s just amazing that you do what you do. I really appreciate it and I’m sure all of those families that you’ve supported over the years have, as well.
Dr. Roseann: It’s a pleasure to be here. And if this resonates with you and you know or care about somebody who has OCD or you think now might - now that you’ve heard some of the signs and symptoms, share this podcast with them.
Me: Yes, for sure. And I am going to put in the description all of your links and contact information so if families want to get in touch with you for more information or to start working together, and see where they can find your book “It’s Gonna Be Okay” - all of that will be included in the link below. Thank you agin so much. Is there anything else from your end before we wrap up today?
Dr. Roseann: You know, just always trust your instincts and never give up hope. You can always find a way to change mental health.
Me: That is great advice. And that hope component is very, very important. There is always hope. We aren’t stuck with the brain we have.
Dr. Roseann: Nope.
Me: We can do things to improve and change.
Dr. Roseann: Absolutely.
Me: Well alright, thanks again Dr. Roseann!
[Medical Disclaimer]
Please consult with your doctor(s) before starting any new mental or physical health improvement program. The advice I offer is not intended to replace that of your medical practitioner. I am not a medical professional, nor am I qualified to diagnose, cure treat, or prevent disease. The advice I provide on this website is intended for a broad and diverse audience, and as such, deals with general lifestyle concepts, not specific healthcare advice. This material disclaims any liability or loss in connection with the advice expressed herein.