Ep.120 Understanding Anxiety and OCD: Early Intervention, Family Support, and Effective Therapies w/ Erin Jones

Show Notes:

Erin Jones, a Licensed Clinical Mental Health Counselor, discusses anxiety and OCD, emphasizing their prevalence and impact. Anxiety affects over 40 million adults, and OCD impacts 1 in 100 children and 1 in 40 adults. Erin explained the differences between general anxiety and OCD, noting that OCD involves obsessions and compulsions. She highlighted common signs in children, such as physical complaints and avoidance behaviors. Erin recommends exposure and response prevention therapy and cognitive behavioral therapy as effective treatments. She also addresses the importance of early intervention and the role of family support in managing these conditions.

• Introduction and Welcome (0:01)
• Getting to Know Erin (1:32)
• Understanding Anxiety and OCD (5:08)
• Identifying Signs of Anxiety and OCD in Children (7:26)
• Diagnosing and Addressing Anxiety and OCD in Children (13:40)
• First Steps for Parents to Address Anxiety and OCD (15:10)
• Effective Strategies for Managing Anxiety and OCD (18:25)
• Addressing Conflicting Advice and Stigma (26:02)
• Understanding the Causes of Anxiety and OCD (29:56)
• Balancing Personal Mental Health and Parenting (33:56)
• Addressing Comorbidities and Seeking Professional Help (34:35)

Episode Notes and Resources:

HER Circle: https://www.herhealthcollective.com/membership

Bull City Anxiety: https://www.bullcityanxiety.com/

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Erin Jones

Wed, Oct 23, 2024 2:06PM • 48:09

SUMMARY KEYWORDS

provider directory, mental health, anxiety disorders, OCD symptoms, exposure therapy, cognitive behavioral therapy, habit reversal, International OCD Foundation, comorbidities, early intervention, family support, medication management, self-compassion, higher functioning, therapy techniques

SPEAKERS

Cindi, Crissy, Erin Jones

Crissy  

Welcome to Mama. Needs a Moment. It is an honor to be chatting with one of our directory experts. Make sure you check out our provider directory on the her health collective website. It is designed to be a one stop shop of the best providers and experts in our community from all the different industries that serve mothers. All the experts included in the directory have been vetted by the her health collective team and are top notch professionals in their respective fields. It’s a way for you to find a provider for your health needs without the overwhelm. Today, we are thrilled to welcome Erin Jones, Licensed Clinical Mental Health Counselor and the senior clinician and intensive treatment program manager at Bull city anxiety and OCD treatment center. Erin is a powerhouse in the world of mental health with years of experience helping people navigate anxiety OCD and other mental health challenges. She is trained in evidence based practices, including exposure and response prevention, cognitive behavioral therapy and Acceptance and Commitment Therapy. She also has experience utilizing Habit Reversal training to treat body focused repetitive behaviors such as skin picking and hair pulling. She is an active professional member of the International OCD Foundation, and serves on the board of OCD North Carolina, and we’ve got a host of very interesting questions to dive into with Erin today. So Erin, thank you so much for being here with us today. We’re really excited to have you.

Erin Jones  

Thank you for having me. 

Crissy  

I’m going to turn it over to Cindi now, and she’s going to ask a fun get to know you question.

Cindi  

This is great because we get to meet you professionally through our questions, but I have the opportunity to have a random question, and it’s getting to know you personally. So I really like this piece of our interview with you. So pick a number between one and 20, and then this number will correspond with a question, and I don’t even know what it is.

Erin Jones  

Oh, okay, I’ll go with 20.

Cindi  

Good. What do you think is the meaning of life? We’re digging deep now.

Erin Jones  

Oh, my gosh, that’s like, not even a warm up question. I think the meaning of life is seriously what you make it, you know, I think we might get into this today a little bit too, but it’s what you want it to be. It’s living life according to your values. And that can change a lot, but just doing things that are meaningful to you. I’m gonna keep it simple,

Cindi  

yeah, oh my gosh. It’s beautiful. It’s beautiful. Great answer to the question I keep watching Crissy in my video because she keeps laughing and laughing and laughing. 

Crissy  

I mean, I was, I wasn’t just chuckling. I was like laughing there. That was not a warm up question. You’re right, but let’s dive in deep. Oh my goodness, I love it. Anxiety disorders are the most common mental health issue in the US, affecting over 40 million adults, and for OCD, it affects about one in 100 children and one in 40 adults. So these are issues that are prevalent in our society and impacting a lot of people. Understanding these conditions can really help in creating supportive environments at home and school. So Aaron, I want to start with the basics. Here. Can you explain what anxiety and OCD are and how they can impact daily life for both children and adults?

Erin Jones  

Yeah, so great question, because there are some differences. I think anxiety besides just being a feeling that we have. But, you know, general anxiety disorder, anxiety, when diagnosed, is really when there’s excessive worry in someone’s life. Same for children or adults, just about a variety of things they do tend to be a little bit more of, you know, things that are or could be happening in the child’s life or the adult’s life. So you know, just being generally worried about school or grades, friendships, you know, being separated from your parents. But when that is happening, when your parents are going out, or when you’re at school, you know, again, not to say that more OCD worries aren’t real necessarily, but more general anxiety tends to be worries about a variety of things, but to the point where it’s impacting the person’s life. The things I listed offer things that we can all worry about, and that’s part of being a person. But when somebody has anxiety. They may especially children, they may come out more of them complaining about stomach aches, headaches, wanting to stay home from school, repeatedly, expressing a lot of worries, or maybe wanting excessive reassurance that everything will be okay. By wanting to avoid things. So again, the difference is really that these variety of worries are becoming impactful on the person’s life. Now, OCD can seem like anxiety. It’s a little bit different, though. I think first it’s it’s really important to say what OCD isn’t. OCD is not. They’re not obsessions that somebody wants to have. We say, like, I’m totally obsessed with this TV show, or my kid is obsessed with trains. They want that they’re all about, that they want to think about trains, or whatever they’re into. OCD, though, is defined by the presence of both obsessions, which are unwanted, bothersome thoughts, images or urges. We don’t like them. We don’t want them. They’re opposite of our worldview, and the compulsions, which are really any attempt, whether in your mind or physically things we could see in an effort to neutralize or get relief from those obsessive thoughts.

Crissy  

It’s so important to have that base definition to start off this conversation, so thank you for that. How often does anxiety and OCD overlap?

Erin Jones  

It’s pretty common to have an overlap, and it can be pretty hard to tell the difference. It’s extremely common to really have a bit of both. OCD tends to be known for, you know, having obsessions and worries that are maybe a bit more catastrophic, unlikely out of the norm when compared to general anxiety. But I don’t think that’s always true. For example, somebody could have obsessions about cleanliness and being very excessively worried that they’re going to get sick, get a stomach bug, get other people sick. That could be a concern in general anxiety too, but with OCD, we’re often going to see quite a bit more effort to try to mitigate that risk or neutralize but it’s extremely common to have both general anxiety and OCD.

Crissy  

Many parents might be grappling with the uncertainty of what OCD and anxiety look like in their children. I know with anxiety you mentioned, a child might complain about a stomach ache or something like that. Yeah, what are some common signs of OCD and anxiety that parents should be aware of? How can these conditions manifest differently in children? I’m specifically thinking of different age groups too. So you know, if I’m looking at my child, seven year old versus Cindi, looking at her kids who are older, 14, you know, right? What might that difference be?

Erin Jones  

Yeah, absolutely. And in terms of, like, the two different diagnoses in the age groups, I’ll, I’ll get into it and bring me back if I need to come back to something. But it is hard to tell. First of all, just for all the parents out there, it’s want to normalize it. It is challenging to tell. I think you know signs for anxiety, especially in younger children, because younger children can have a hard time. They might not even know, like, what worrying about, right? Often they do, and hopefully they’ll tell you, but you might see more physical complaints that are not, you know, defined biomedical conditions, so stomach aches, headaches, trouble, sleeping, more difficulty at school, you know, maybe some eating habits changing where again it’s it’s repeated, right? It’s not for like, a day, or just having a rough week, or something like that. Your child might also start to say a lot of their worries, or maybe they’re asking a lot of questions, bringing up a school test more often and like, Hmm, okay, maybe you’re having some more, some more worries about your test lately. I think the same with older kids and teenagers wanting to maybe pull out of or avoid more friendship or school activities, voicing excessive worries, of course, would be a way to tell they’re talking about it more and same thing, more physical complaints, trouble, sleeping. All these things could show up with OCD, too. The thing with OCD is again it it can be very hard to tell, but there can be some signs or signals to look out for. Again, OCD is defined by the presence of obsessive thoughts and compulsive behaviors. They can be like a what if type of worry they can be. This is why, especially younger kids, can’t really always explain what it is that they’re worried about. It could just be like an urge sometimes, like, I just, I’m gonna feel gross if I don’t do this thing, my brain’s telling me to do something just doesn’t feel right. It can also come up as like a disturbing image. You know, I don’t know if you’ve just ever been like, driving or cooking or doing things about your life, and you. Know, have an image come up about death or or harm or sexual things, or really just anything that seems kind of random and bothersome and opposite of your values. So it can also be things like that. Those can all be obsessions. Compulsions are really anything that our brain feels obligated to do, to try to because, because we don’t like the obsessions, right? I have a really bothersome, scary image. I want to get rid of that so we feel anxious from it. Fire alarm in the brains going off, and we want to do something to try to be rid of that, or neutralize it. So the hard part about compulsions that we can’t always see them. Somebody could be compulsively trying to replace a bad thought in their mind, or compulsively praying, which is different than a a wanted, regular prayer ritual. So sometimes we can’t see it. And I think these would be areas where we might get into talking about our kids and teens if we suspect OCD, but especially with younger kids, we might see a lot more overt behaviors, things we can see so maybe more frequent superstitious behaviors, repeating steps, having to go and do big behaviors repeatedly. Younger and teenagers, you might notice things taking more time. So for example, I always laugh when I say this, because I know, like, teens can start taking a long time to get ready for, you know, social events in school, but if there’s just a lot more extended time, like, wait now my kid is taking a really, really long time in the bathroom, in the shower, a really, really long time doing schoolwork because compulsions. Can, you know, having to repeat things or getting distracted by intrusive thoughts, can also come up with schoolwork. You may also notice things like you’re having to buy, if it’s more cleaning based, okay, I’m really having to buy a lot of Lysol wipes. All of a sudden, we’re having to buy a lot more toilet paper and multiple bars of soap for the shower. So things that I think start to become a lot longer in the routine that could be indicative of more repeated behaviors. It can also be asking frequently for reassurance. You know, do you think that something bad is going to happen, mom? Do you think that I really actually might do something bad one day again, repeatedly, and really seeming to come from a place of worry? Research can be compulsive. Researching things online, even strong avoidance can be a compulsion. So like I am, I had a bad thought when I was going down this hallway at school, so I am not going to walk down that hallway anymore, because I don’t want to have that thought. It can be avoidance too. They can also be mental. It’s like I was saying earlier. It could be if I have this unwanted or bad thought, I want to think about a good one, to try to replace it, or say a prayer, say a series of numbers in my mind, or maybe excessively, try to work through it or or get rid of it. So those, those would be kind of the main and of course, could be such a variety of themes and things that can come up, but that tends to be the main way that obsessions and compulsions happen.

Cindi  

Thank you so much. I think that’s really valuable to hear those defined in that way that an obsession starts as maybe a thought, but then in order to deal with that feeling, the anxiety that it’s provoking. You do an action for it, and I’ll be very vulnerable right now and tell you, when I was little, one of my obsessions and compulsions was okay. And mind you, this was like seven years old, I would be playing with my toys, and I was very much about germs, and if I felt like my toys got contaminated. I would literally blow on my toys until they felt clean, and it was to the point where I would get lightheaded. I would blow on them so much so, yeah, I definitely relate in everything that you said resonates with me.

Crissy  

I’m interested to know, Are there guidelines as to how early a child can be diagnosed for either anxiety or OCD.

Erin Jones  

So you know, kids as five or younger can really be diagnosed with OCD or anxiety. I think it’s harder to spot OCD prior to that age, the typical onset for OCD is usually the late teen to early college years, but I believe it’s about a third. There is a portion of kids who do start to see symptoms in the later elementary school years, especially boys. It’s more recent that I believe, like younger adults, it’s more common in females and. It’s again challenging because, you know, somebody could maybe have more intrusive thoughts or have a slower onset, and it’s more noticeable in the later years. You know, we don’t know exactly why, especially for OCD, but yeah, it can be diagnosed very young, especially if we’re seeing a lot of those behaviors changing at home, or especially those physical complaints, wanting to avoid things.

Crissy  

Once parents identify those signs, what are the first steps they should take to address their concerns without jumping to conclusions, becoming overwhelmed? Those are two things I imagine might happen a lot if a parent is faced with this scenario.

Erin Jones  

Absolutely it’s hard if you’re especially if you’re seeing your kid struggling, you’re seeing anxiety symptoms, it’s absolutely hard to not jump to conclusions or start to panic. It’s good to notice. First of all, you know, I want to validate for parents that I’d say, essentially, everyone that I meet and work with that’s a little older who maybe just, maybe just family didn’t notice, or they didn’t know they had OCD as a child or teen, till they’re older, they just wish that they knew or someone else knew. So it’s good to know or have some suspicion. I think first steps would be to, you know, plug into some reasonable research. The International OCD foundation is really, I think, the best resource hub, iocdf.org, there’s huge lists of books. There’s kind of some more general, a lot of things that I’m summarizing today. What are some signs of OCD in children and adults versus anxiety. So that could be a good place to start and help you kind of just keep an eye on things. And also, this is hard to do if, if you’re worried, but try to be curious. You know, rather than panicking or seeing this as something that we have to, we have to get rid of, or this is going to be a death sentence in our home. Let’s try to be curious and and ask some questions to our kids. So, for example, maybe not right in the moment, right? But like, Hey, I noticed that you spend a lot of time in the bathroom lately. Like, is everything going okay? What’s going on with that? Again, try to approach some of those situations with curiosity and see if you can get a little more info on what’s going on at home.

Cindi  

I’m so thrilled that there has been such a increase in knowledge and research done on OCD, because I have struggled with OCD throughout my entire life, and I’m in my 40s, and when I was young, I was showing signs of the obsessiveness and compulsions, but my parents didn’t know what it was. They thought it was stages that I was going through, because that’s kind of what you see in OCD. They kind of morph, they change. And so something that might have been an obsessiveness and compulsions done for that change over the years and then changes to something else. So at one point, I was washing my hands a lot, like you had referenced the soaps, and a lot of mine was about germs. It’s really exciting to see the increase in research. I also wanted to draw attention to comorbidities, meaning, sometimes when a child might be diagnosed with ADHD, is it common for OCD to be a comorbid factor as well? Or do you normally see OCD standing out on its own?

Erin Jones  

Yeah, so I mean, sometimes we see it on its own, but it doesn’t exist in a in a vacuum, so it’s extremely common to be comorbid and also show up like other diagnoses, right? So sometimes, if kids and adults can have some repetitive behaviors, sometimes it can look a lot like things like autism spectrum disorder, ADHD. But yes, it can be, very co morbid with ADHD. Depression is extremely common with folks with OCD, as we mentioned earlier, general anxiety and often autism spectrum disorder. And you know, I think, like I said, it doesn’t exist in a in a vacuum, so I think we just have to make those considerations in understanding our kids and seeing what they need and going through treatment, but either way, there’s still reliable ways to work on OCD, even with comorbidities.

Cindi  

Sure! And now I’d like to turn it over towards some ways that we can help ourselves and our kiddos. Cognitive behavioral therapy, otherwise known as CBT, is often cited as one of the most effective treatments for both anxiety and OCD, but Erin, with your extensive training and background in this area, we know you may have some fresh perspectives and additional techniques that can make a big difference in day to day life we’re all about. I. Practical advice here, what are some effective strategies or tools that you recommend for managing anxiety and OCD? 

Erin Jones  

Yeah, absolutely. So first, I think, if you haven’t gotten to this point yet as a family, do some learning. I said earlier, do some research, I think especially for something that really needs specialty work like OCD, I, you know, would lean more towards a lot of the things I’m going to mention that they happen or be educated in a therapy setting, right? But, you know, talking openly with our kids or teens or whoever is, is the person experiencing OCD, you know, there’s again, the iocdf International, OCD Foundation has huge lists of books. You know what? What book is going to be good to use? Can vary on age, but you can take a look or watch inside out and and talk about feelings together, but talk about it. I think it’s, it’s often helpful to also say what not to do. And with OCD anxiety, our kids are struggling, like, I would say, your drive is going to be to want to, like, relieve that as much as possible, right? Like my kid is struggling. I want to get rid of this anxiety, and we obviously don’t want to, you know, make our kids suffer, but we do want to actually avoid accommodating to to the fears and the OCD, so I’ll explain that. I know we’re looking for, like brief, practical strategies, but you know they’re they’re not that short, if we are answering all of those reassurance questions multiple times in a row, right? We’re like, no, no. Like you’re not going to get sick from those toys. Like they’re perfectly clean. Don’t worry about it. We love again. Don’t worry about it. Everything’s fine. Don’t worry about it. We’re just telling the brain you should keep staying in this loop. You should ask the question every time you get the intrusive thought, it’s bad to be anxious. Are you buying a lot of extra cleaning supplies? Are you changing your routine, for example, like if there’s a particular bathroom in the home that your kid or teen is is using and performing compulsive rituals in? Are you avoiding that bathroom so that they can use it. So again, in terms of more practical strategies, we want to try to really get the family more into their quote, normal routine. You actually don’t really want to be doing things that are too different from your regular routine. Otherwise it accommodates the anxiety and says, hey, the anxiety should be paid attention to in this way. We should all give in to the anxiety, but instead, we want to work together as a family, to not let the anxiety and OCD run the household, per se. So in summary, we want to be and this is helpful to do with a therapist, right? But we want to be looking for things that we’re doing, maybe outside of the, quote, normal routine to kind of aid to or try to give temporary relief to the anxiety. And we want to try to start to pick some of those things apart and explain to our kids, hey, I’m here for you. But you know, buying all these extra cleaning supplies is actually just telling your anxiety that you should keep being worried about this. We’re going to work on it together and get back into life without the anxiety being in the driver’s seat.

Cindi  

I know that from my own personal experiences, when you try to do that, there’s often a breakdown with the child. There’s a lot of yelling or fussing. Do you have any tips on making it through that hurdle? Because oftentimes we’re supporting their rituals because we don’t have time. I know this sounds awful, but we don’t have time during in the mornings to mess with them breaking down, or at night, we’re just trying to get them to bed. Do you have any tips in that regard?

Erin Jones  

Oh, absolutely. I mean, and it anybody listening? If you’re thinking, like, oh my gosh, am I giving into all this anxiety? Like, please don’t beat yourself up about that. Like, I’ve been there too, and it’s you want to tell my kid? Like, yeah, yeah, you’re going to be fine. Like, just go to sleep now, right? Or we going to get out the door exactly, of course, and I think again, it’s, it’s in our nature to want to give reassurance and do these things as parents, and that’s why I do really think that, especially for something that just really needs specialized care, like OCD, that you do want to build a structure with a therapist to work on this together. You know you’re going to get the tools to feel more confident working through that. But you know, if you’re having an implemented plan and your kids breaking down, you can be there for them, be supportive, kind of like what we would say for a kid just melting down in general, right? Like, hey, I’m. I’m here for you, you know, given the hugs and but I think we can still do the breathing and some of the calm down techniques, but we just don’t want to abruptly try to get rid of that, right? Because, again, it will just say, like, Okay, we should be letting OCD rule the house. It’s very, very hard, I think also for younger kids. I mean, with teens too, like, we’re all working on it together, because it is going to be hard, and there’s often an implementation of a reward system, or some therapists and families do it like, Okay, we’re going to work on kind of like, removing this cleaning item or facing this difficult situation together, going up a step ladder. And we’re going to use some some bravery tickets. You know, every time we do this together, we’ll, we’ll get a bravery ticket or something like that. And we can work towards doing like, a fun family activity together, for conquering these things together.

Cindi  

That’s great, just to know that the resources are out there, that people like you are there to help support through there are two different areas that I really want to talk about. One is conflicting advice. There’s lots. I mean, with social media, you’re going to get a lot of depending on the different people that you are following. If you are struggling with this in your home, you’re obviously going to go on and try to find help, but there is going to be conflicting advice, and it’s hard to know what’s really helpful. So are there common myths about these strategies that you’d like to debunk, and then you’ve talked a little bit about this, but if you could help provide some effective ways to talk about mental health with our kids? Would you be able to discuss those two areas?

Erin Jones  

Absolutely. So I think OCD itself comes with a lot of a lot of stigma, you know, just I think it can be hard for kids and adults to talk about it. So I think just learning more, being there for your kids, really trying to understand, even giving some some personal relating, like you did with us, Cindy, will help, I think, help your kids be more comfortable there. I think are quite a bit of stigma against these techniques. You know what I’m talking about is often involved in exposure and Response Prevention therapy, where families and their parents are working on intentionally and ethically getting into situations where they still have that that thought or urge and feel anxious, but they’re delaying or interrupting or messing up or withholding the compulsions. And the reason why I say that is because if you read about that you could get the impression that it’s a bad thing to do again. Why would I want to like, not give reassurance, like, I want my kid to feel better? Why would I not like, of course, right? Why would you not want to buy the extra cleaning supplies? It makes them feel better, and you you know, things are already so hard, and you just want them to be okay. Why isn’t there like a quick strategy to make everyone feel better from OCD? Sometimes it does get the impression that you’re being too harsh or hurting your kids by doing this kind of approach. But here’s the thing, you’re you’re actually helping. You know, everyone can be on the same team and work together, but if there’s that cycle of again, the obsessions, the unwanted thoughts and the compulsions, and they kind of become like rules and they have to happen, then logically, we have to work on breaking that and showing the brain Hey, we actually don’t have to do compulsions, or at least to that extent, Every time that these worries come up, maybe we just kind of have bother some thoughts sometimes, and we feel anxious, and we don’t really have to do anything about it. They’re just thoughts. So, you know, in that regard, then I think it’s really important for people to know that these are evidence based strategies, and you can still, like, love your kid and do things for them and and do things they enjoy and like, give them comfort and hugs and support in that way, without accommodating to the anxiety is really important in terms of how to talk to your kid. Yes, I think it can be tough to talk about it. Kids and teens have to be willing to disclose it again. I think step one is just, it’s hard for me to do, slow down, be curious, meaning, you know, kind of think about if you were sort of just wanting to learn a little more, rather than trying to, like, solve a mystery or figure out what the bad thing is, just like, Huh? Hey, I’ve noticed, you know, you’ve been asking for a lot more help with your homework, or you’ve, you’ve been spending a really, really long time like reading for school, you know, yeah, what’s tell me what’s going on with that, and see what info you get there. You could use some of the books or things that we’ve discussed another way. Aid that could help to talk with your kids and teens, or for yourself with OCD, is to really try to separate the OCD from the person. And what I mean by that is you can call it the OCD. You can give it a name. We can use it like we do this with adults too, but with kids, you could call it like there’s a book that calls it the OCD flee. I’ve heard of kids calling it the SAR SAR, the stupid, annoying rules, and the reason is give it an expletive, like whatever you want to call it. And the reason why we do that, and why I say that in parents talking with their kids is because we want people to know that you are not your OCD again. These are thoughts you have. It’s just kind of the OCD flee, like whispering and saying, like something bad is going to happen, and you want to be working to see that as something that your kid can observe and know, okay, yeah, like the flea bothers me sometimes, but I don’t have to let it take over everything. Again. Adults do that too. So I hope that those are some good tips to you know, at least feel a little more comfortable and get started talking about these things with your kids.

Crissy  

Thank you for that Erin, very much. I think it’s very important to have not only the definitions of what these things are, but also what we can do when it appears in our lives, and how we can respond to that. We’ve talked a lot about those definitions and how we can respond, but I’m interested in backing up just a little bit, and actually, I would love to know what information or research, or what knowledge we have at this point about anxiety and OCD and why it appears in certain individuals like depression. Is there a genetic, biological component, or is it environmental? Is it a mix of all these factors? What do we know about that?

Erin Jones  

Yeah, so I can probably go ahead and just quickly, like, debunk things you might see on the internet. We don’t know. We don’t know for sure yet. So there’s been a lot of research. We do tend to see OCD in families. We’ll see family history. But there hasn’t been, like, one replicated genetic study saying, like, Hey, this is the gene for OCD. So we don’t know. We still have a lot more to learn. Sometimes there’s folks without family history who get it. There are folks who get it at younger ages versus older. So we really don’t know. There is, however, a ton of reliable research on the treatment or management of OCD through exposure and Response Prevention and these things that are under the cognitive behavioral therapy umbrella.

Crissy  

I imagine these diagnoses are relatively recent, the first diagnosis of anxiety or OCD,

Erin Jones  

yeah, I believe really only within the past, like even exposure and response prevention is, you know, has, has only really been happening in our lifetimes. So we need more research. But even just in the, you know, under 10 years that I’ve been specialized, I think that I’ve seen so many things changing and more understanding and awareness. So I feel hopeful that we’re going to be learning a lot more, because we also don’t even know. Like, why again, for one person, it could be like, Why is one person obsessed with fear of contamination or getting others sick? And why is somebody else more obsessed with kind of, more repetitive, scary, intrusive thoughts, besides the fact that it’s opposite from the person’s values. We don’t really know why certain things kind of light the match. It’s not always like, hey, this thing was taught to you in your childhood, or this traumatic event happened sometimes, but we just don’t know reliably enough to say what causes it for people. 

Crissy  

Yeah, mental health in general, I feel is having more slowly, but having more of that stigma removed, and getting more research and being more publicized, and just kind of having that layer taken off where we are more comfortable talking about it and being aware of these things, as you mentioned, the studies do show that therapy and treatment is effective. It also shows us that early intervention can significantly improve outcomes for children with anxiety and OCD. So recognizing the signs which you’ve previously discussed with us early on, and knowing when to seek help can be crucial for effective management. But let’s be real, because sometimes it can be really tough for parents to know when to step in and seek help. In particular, I’m thinking about as a parent, you have a child that is maybe prone to being shy or being perfectionist. Or just certain tendencies. And I think as parents, it’s really challenging to decide, is this just a natural behavior, is this a phase that they’re going to kind of come out of at some point in the future? When do we decide that this is something more? And I know you touched on this a little bit, but I’m still stuck here a little bit in, you know, looking at your child and saying, her personality, is this? Is this a personality? Is she quirky? Does he have, like, a certain behavior that’s just because of who he is? When does it kind of cross over? And what advice would you give to parents who might be unsure about whether or not their child’s behavior warrants professional support. It sounds like, in some situations, it’s very obvious, but I feel like there’s a big middle ground, a gray area where a lot of parents might be unsure.

Erin Jones  

Yeah, absolutely. It’s a great question, and it can be a lot of uncertainty, which is also essentially what anxiety and OCD is. So it’s hard to work through that, especially when it’s your kid. I think, yeah, kids can tend to be more perfectionist or shy and or maybe even through their behaviors, like we can all do some repetitive things sometimes, or be very set in how we want to do our bedtimes and things like that. Again, it can seem very blended, but anxiety and OCD is not somebody’s personality, but even with things like perfectionism and your personality, it’s still more about how much is life being impaired or impacted by this, right? So maybe, okay, I get a little more worried, like every time I have a needle phobia, I’m going to go with that example, right? Every time I go get a shot, I get really nervous, and we kind of work through it, and that’s okay, you know, is your kid really starting to get excessively anxious every time that they have a test at school? Are they spending more time? I think again, that’s a big marker. Things are taking more time, like doing homework for the kid who maybe struggles with perfectionism, you know, more time and excessive attention to the things that they’re worried about to the point where it’s affecting life. Are they not able to do as much of the things that they love to do, or that your family loves to do? And you know, you’re right, Crissy, there’s not always going to be it tends to happen gradually. And there’s not always this, like, wait now it’s hours on the homework, but I would say, if you’re really not sure, like I said, Get curious and check in with your kid and just kind of see how they’re doing and see if a discussion comes up. But it also doesn’t hurt to look some things up and maybe even do a consultation call with a therapist and say, Hey, like, here’s the things I’m noticing. Do you think that more in some even kind of some like educational appointments and more preventative services? 

Cindi  

Erin, we talked a bit about treatments in terms of therapy, but I also know that there’s medication and that there’s newer advances, such as things that are being cleared by the FDA to help, and it’s going to change definitely, depending on the age of the individual that we’re talking about. So an adult is going to have a different treatment plan than a child, of course, but I was just wondering if you could touch base on some of the medications, advancements and other treatments that can go together with the therapy.

Erin Jones  

Absolutely, there has been quite a bit of research done on medication for OCD, adults and kids. It does tend to be SSRIs and, you know, I don’t prescribe medication, you know, I do the therapy. But that can be an extremely, I think, challenging and difficult question for a lot of parents, like, I don’t, I don’t want to medicate my kid. What should I do? And know that there is a lot of research out there on medication management for OCD. It can help. There are specialists, psychiatrists, or you can start with asking your pediatrician some questions, but really, ultimately, there’s, you know, people who tend to manage or get better with only medication, with only therapy. But it’s, it’s really the combination of, let’s say, the right medication, and exposure and Response Prevention therapy that tends to be the most reliable. There are things that will come out about diet, or, you know, maybe other therapies. And I of course, like having a healthy diet is important for all of us, but there is not a cure for OCD. So just keep in mind that, you know, things that you do that are just kind of within, like an ideal lifestyle for you can be great, but they’re not going to, you know, help, help manage OCD, like, potentially medication and that the right therapy can do.

Crissy  

Thank you so much, Erin. I just want to note that in the previous conversation, the overall gist of what. I heard that what it comes down to is how much it’s impacting your life as to that decision to pursue treatment. Is that accurate?

Erin Jones  

Yes. And I would say again that if you’re really unsure, reach out and ask, you know, consult with a therapist, or do some research on the international OCD foundation. But yes, I think the biggest marker would be is, is your kid having a hard time? You know? Is this affecting their life in some way?

Crissy  

 And that applies to anxiety and OCD, impacting absolutely children and adults as well.

Erin Jones  

Yeah, so am I maybe just like, a little bit worried sometimes, here and there that my kids are going to get sick at daycare, or am I doing all these extra things in my rituals? Am I having a hard time like keeping track of what I’m doing during the work day? Am I having a hard time sleeping? You know? Again, it’s also okay for kids and adults to maybe be a bit more like higher functioning and getting by with their anxiety and still get some help, you know. So if, of course, I think if, if you’re when in doubt, or if you think that it’s there, do some consulting with a provider and and see if some, even some brief therapy, could be helpful in just managing

Crissy  

I’m glad you mentioned the higher functioning piece, because I’m sure that that might impact many, many individuals, many listeners, listening. Yeah, there’s kind of that, that middle ground there. And if you’ve just gone through your whole life being used to certain behaviors and have still managed to make it through, right, it can kind of fly under the radar, like get pushed to the back burner a little bit. So, yeah, I think that’s important to mention that piece, that there can be higher functioning I also wonder do things like anxiety and OCD ebb and flow, like, does certain stress in your life kind of exacerbate these conditions and bring them to the forefront? And then there’s moments in your life where they kind of recede to the background and you feel like there’s nothing to be concerned about, or is it kind of just always bubbling under the surface there?

Erin Jones  

Yes, that can happen. So it can depend on the person. I think sometimes maybe that’s where that, like, higher functioning label might come in, right? If, like, well, I get a little anxious, or I have a harder time at, like, back to school time, or can actually be extremely common for folks to feel more anxious during breaks and weekends and unstructured time, but wait like they’re still getting okay grades. And you know, so again, it is very hard to tell and Cindy, I’ve also had some OCD symptoms throughout my life, and I think that I wish that I had noticed more, or maybe consulted more and understood that even though I was like, you know, working and going to school and getting good grades, that it could still have been something that I talked about sooner. But anyway, yes, some people do see it more cyclical, maybe triggered by like illness season or changes in your life, like moving or getting back into school or a new environment for other people, it is kind of just there on a daily basis. So it depends. 

Crissy  

Erin, many mothers are, as we kind of just talked about, they’re managing their own OCD and anxiety while juggling a lot of family responsibilities like back to school time and their jobs and things like this. What strategies can a mother use to balance her own mental health needs with the demands of parenting? How can we effectively manage these symptoms of anxiety and or OCD while still being present for our families?

Erin Jones  

I would say, in a broader scale, because you know, I’m there too, and at least you two. Know, I’ve got two small kids and I work and also doing all the things you’re probably gonna have to plan it out. You know, make a plan, whether it’s a therapy session or you keep up with your own med appointments from time to time. Use your supports groups like her collective right to connect with other people, sometimes in the more general sense, and then day to day, like, yeah, you know, it’s hard if people say, like, just take a break, but if your partner’s away and both your kids are sick or so, I think, you know, having to think, How can I adapt and modify throughout the day, where maybe, if I’ve even got to, like, bring in a little fun activity with the kids, step into the bathroom and maybe take a breath and do some stretching. And I teach a lot of clients about using self compassion, which can be something really great to incorporate into therapy too. And we can do that if our hands are full or they aren’t, but just stopping going, Okay, I see you. This is really hard. You’re having a tough time. Got this and yeah, so I think again, in a bigger sense, like plan it out. Life is busy and you’re gonna have to plan those ways to care for yourself and manage. And maybe some of those, I guess, quicker moments during the day where you can get in care for yourself.

Cindi  

As a mom who is very prone to anxiety, has a history of OCD, I’m right there with all of you moms out there that struggle with it, and I also want to draw attention to how my OCD has ebbed and flowed over the years. When I was young and before heading to college, I had more of the obsessive compulsions, type of behaviors with OCD, and now that I’m older, I’ve matured. I’ve been through lots of therapy. I have coping skills. I’ve noticed that it tends to show more in anxiety, in some of my thinking, not being able to let go of perhaps conversations that I have with people. So it’s it’s definitely a journey. It’s a journey. And I do notice at times where I have more stress in my life, it flares more I might have more intrusive thoughts. I might have more magical thinking, type of things. Going back to comorbidity, let’s say your child has been diagnosed with ADHD, or they’ve been placed on the spectrum, but you’re also noticing OCD symptoms. What do you tackle first? Do you tackle one before the other, or can you do them at the same time?

Erin Jones  

You can care for them at the same time, so exposure and response prevention, therapy? ERP, I think should often still be done and engaged in, despite comorbidities. I think the only times where we need to say, like, hey, this thing really needs to be addressed. First is, if there’s really a major safety concern that’s happening where a child may want to harm themselves more acutely, or just the meltdowns are becoming extremely destructive, we may need to look at, okay, how can we get a little bit more stability there, but otherwise, from some of those circumstances, we’ll consider those comorbidities and maybe get additional therapy support if we have to, but we can still do ERP,

Cindi  

And then at your office, you often see adults. Is there a place that you recommend for pediatric care of OCD, or do you have providers at your office as well that just do pediatric?

Erin Jones  

So we see kids too. A few of us do at Bull city anxiety. I’ve worked with kids for many years, and still see kids and adults. So I think we would be one of the main places. There are some few other providers in North Carolina. Again, another plug for international OCD foundation, but they have a directory, which I say that it’s important to find people who are specialized in OCD. At the time we’re recording, we’re going to have a new office soon in the Chapel Hill area, so we’ll have more in person sessions, hopefully for more kiddos and adults.

Crissy  

That’s exciting! Well, thank you so much. This time has been very valuable. We appreciate you very much.

Erin Jones  

Thank you for having me.