Welcome back to another episode! If you'd like to receive my weekly newsletter, please sign up here. And you can also sign up for my free monthly book club here. I'll be talking about how to raise kids who aren't spoiled this Wednesday, July 17 at 12 PM PST, presenting Ron Lieder's excellent book "The Opposite of Spoiled".

In this final episode of season one of the Parent Doctor Podcast, Dr. Marissa Caudill reflects on the common mental health issues children face that she discussed earlier in the season. She then goes on to highlight a significant shift in her healing approach over recent years. Traditionally, medical training, particularly in mental health, focuses on diagnosing and labeling problems. This practice is driven by the healthcare system, where a diagnosis is essential for insurance billing. Consequently, doctors often feel compelled to find a diagnosis to ensure payment, even if it means overlooking deeper, underlying issues.

This system is especially problematic for children. When children display symptoms like behavioral issues or anxiety, there are often underlying reasons, but the current system prioritizes assigning a diagnosis and prescribing medication rather than exploring familial and environmental factors that may contribute to a child's symptoms.

Dr. Caudill provides examples to illustrate her point. She has treated children of undocumented immigrants who live under constant fear of deportation, leading to immense stress. Such situations might be mislabeled as anxiety disorders when the real issue is the family's precarious situation. Similarly, children who have lost a parent experience profound grief, which might be incorrectly diagnosed as depression. In these cases, addressing the family's emotional dynamics and providing appropriate therapy can be more beneficial than merely prescribing medication.

A key insight Dr. Caudill shares is the importance of recognizing that our true selves are separate from our bodies and minds. Despite physical changes over time, our core identity remains constant. Our true self existed before we were born and will remain after our bodies die. Our true self can never be "ill".

Mental illnesses stems from an overactive "downstairs brain"—the part of our brain responsible for survival instincts (amygdala and limbic system). This overactivity can and often does dominate our thoughts and behaviors, leading to various mental health issues.

To manage this, we need to learn ways to shift control to our "upstairs brain" (prefrontal cortex) or, ideally, even beyond that, to the awareness of our true self. Practicing mindfulness and connecting with our true selves can help us recognize and manage the signals from our downstairs brain.

Dr. Caudill emphasizes four pillars of empowered parenting, achieved by connecting with our true selves, which provides a source of infinite patience and endless love:

1. Defining Direction: Leading families with clear values and goals, involving children in this process to help them form their identities. Helping our kids connect with their true selves will help them so much throughout their lives.

2. Emotion Regulation: Demonstrating control over our emotions to set an example for our children. By connecting to our true self, we tap into a resource of infinite patience and love.

3. Practicing Gratitude: Regularly recognizing and sharing our abundance, which fosters a sense of security and happiness. In doing so, we further embrace our safe true self, and disengage from the survival brain.

4. Embracing Failure: Failure is fertilizer for growth. When we are sure of our true self, we don't have to be afraid of failure.

These principles help parents and children manage stress and reduce the risk of mental illness. Dr. Caudill invites parents to engage in future episodes by sharing their challenges and experiences. Recordings for season two will resume in August. If you’d like to join me on an episode, please email hello@theparentdoctor.com.

Hello, and welcome back to The Parent Doctor Podcast. I'm your host, Dr. Marissa Caudill. Please rate and follow this podcast to help spread this resource, and be sure to visit ⁠⁠theparentdoctor.com⁠⁠ to sign up for my ⁠⁠newsletter⁠⁠ or join the monthly ⁠⁠book club⁠⁠. Today, we'll discuss Obsessive-Compulsive Disorder (OCD), the final topic of our introductory season.

Over the past 15 years as a child psychiatrist, I've identified the ten most common reasons parents bring their kids to see me. This podcast series covers these concerns, with today's focus on OCD.

OCD is characterized by obsessions (persistent, intrusive thoughts) and compulsions (repetitive behaviors to alleviate anxiety). These symptoms must cause significant distress and impair daily functioning to be diagnosed. Early intervention and treatment significantly improve outcomes.

While I am a board-certified child psychiatrist, this podcast is not a substitute for professional assessment, diagnosis, or treatment. For personalized attention, consult a local professional, which you can find through resources like psychologytoday.com or your pediatrician.

OCD often involves over-activation of primitive brain pathways that regulate our sense of safety. Thought-action fusion, the belief that thinking or doing something will influence the future, is common in OCD and needs to be addressed through cognitive behavioral therapy (CBT), specifically exposure and response prevention (ERP).

In rare cases, OCD symptoms might result from autoimmune conditions like PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) or PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). These conditions involve sudden onset OCD or other psychiatric symptoms following an infection. If you suspect PANDAS or PANS, seek care from a tertiary care center.

Treatment for OCD involves stopping the accommodation of OCD-driven behaviors, which can be challenging for families. Parents often inadvertently reinforce OCD by trying to maintain peace at home. However, this can strengthen OCD symptoms, making them harder to treat. Therapy involves gradually exposing the child to anxiety-provoking situations to help them learn that their fears are unfounded.

For more resources, I'll provide links to books for kids and teens, and the Leaky Brakes website, which offers helpful information on OCD and tic disorders. I'll also include a resource called Mightier, an app that helps kids build self-regulation skills.

In the next episode, I'll discuss the spiritual aspect of mental health. Spirituality can play a role in helping individuals with OCD separate themselves from their thoughts and emotions, aiding in treatment and recovery.

That's it for today's episode. If you have any questions or topics you'd like to discuss, please email me here. I'm also looking for guests for future episodes, so feel free to reach out if you'd like to participate.

RESOURCES:

https://www.leakybrakes.ca/brake-shop/brake-shop-virtual-clinic/

https://www.mightier.com/

https://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/Obsessive_Compulsive_Disorder_Resource_Center/Home.aspx

https://neuroimmune.org/patient-and-family-resources/what-are-pans-pandas/?gad_source=1&gclid=Cj0KCQjw7ZO0BhDYARIsAFttkCgwvYLKzCo0OnfNMX6FE6Hr-hM8aLYgAOGcxiRcblgAdsJkbNUw690aAuicEALw_wcB

OCD Workbook for kid: https://amzn.to/3W7F9hq

OCD workbook for teens https://amzn.to/3XUQG5j

Take care! 💕 Dr. Marissa

Welcome back to The Parent Doctor Podcast. I’m Dr. Marissa Caudill, a child psychiatrist and mom of two. Please rate and follow this podcast to help spread this resource, and be sure to visit ⁠theparentdoctor.com⁠ to sign up for my ⁠newsletter⁠ or join the monthly ⁠book club⁠. It's totally free and the best part is, you don't need to read the books!

Today’s episode covers a critical but rare topic: psychosis in kids and young adults. Despite its rarity, early detection of thought disorders like schizophrenia and schizoaffective disorder is vital for effective treatment and improved outcomes.

Psychosis typically manifests in late teens to early twenties, with a second peak for women around age 50, often linked to hormonal changes during menopause. Women with a history of postpartum depression, psychosis, or bipolar disorder are at increased risk.

Recognizing symptoms early is crucial. Negative symptoms of schizophrenia include affective flattening (reduced emotional expression), alogia (impaired thinking affecting speech), anhedonia (lack of enjoyment in activities), asociality (reduced desire for social interaction), and avolition (lack of motivation). Positive symptoms include hallucinations, delusions, disorganized speech and behavior, and catatonia (holding unusual postures for extended periods).

If you notice significant behavioral changes in your child, especially during adolescence, trust your instincts and seek professional help. Early intervention leads to better outcomes, so it’s essential to get an assessment if you’re concerned.

Risk factors for psychosis include genetics, trauma, drug use, and stress. While most people with these risk factors won’t develop psychosis, a susceptible brain combined with these triggers can lead to the illness.

Programs like the NIH’s RAISE and EpiNet offer community-based, coordinated specialty care, including psychotherapy, family support, medication management, and more. I’ll provide links to these programs and a PDF about understanding psychosis in the show notes.

Spirituality can play a role in mental health, helping individuals separate their true self from their thoughts and emotions. For caregivers, connecting spiritually and offering nonjudgmental support is crucial.

If you or your child are experiencing psychosis, seek support from organizations like NAMI. Early detection and treatment lead to better outcomes, so don’t hesitate to seek help if you notice concerning changes.

In our next episode, we’ll discuss OCD, wrapping up our clinical topics for this season before a summer break. Thank you for listening, and remember, you’re not alone. Effective treatments and new medications offer hope for better outcomes.

For more information, visit theparentdoctor.com. You can sign up for my free newsletter and join our monthly book club. In July 2024, we’ll discuss “The Opposite of Spoiled” by Ron Lieber, a valuable resource on raising financially responsible kids.

If you found this episode helpful, please take a moment to rate and follow the podcast on whatever platform you're listening on. Your support helps us reach more parents in need of guidance.

Take care, and talk to you soon. Bye!

RESOURCES:

https://www.nimh.nih.gov/research/research-funded-by-nimh/research-initiatives/early-psychosis-intervention-network-epinet

https://nationalepinet.org/

NAMI.org

https://www.nimh.nih.gov/sites/default/files/documents/health/publications/understanding-psychosis/23-MH-8110-Understanding-Psychosis.pdf

Join me next Friday for episode 11.

Take care! 💕 Dr. Marissa