Part V: Eating Disorders and Obsessive-Compulsive Disorder

Dr. David Smith looks at the effects and symptoms of deadly illnesses like bulimia and anorexia nervosa.

When it is more than anxiety or depression: looking at eating disorders and obsessive-compulsive disorder.

The ages between 12 to 24 are challenging for almost all youth.

The biological, social, physical and psychological path to adulthood is not easy, even under the best of circumstances. But coupled with that tough journey is the fact that 75 per cent of all mental health disorders first show up in these teen/young adult years, too. For the majority, the mental health issue is apt to be mild to moderate anxiety or depression; both highly treatable.

A number of other very important mental health issues, however, also tend to arise first in someone’s teen years. Here is some general information and links to resources for two specific issues: eating disorders and obsessive-compulsive disorder.

(Next article, we will talk about bipolar disorder and schizophrenia.)

Part IV: Drugs, Alcohol and Mental Health Problems – Which Came First? (Jan. 20, 2015)

In all cases, if you suspect your child might be suffering from a specific condition talk to your family doctor or contact the Child and Youth Mental Health clinic provided by the Ministry of Children and Family Development in your nearest community. Call Service BC at 1-800-661-8773 to find the nearest MCFD office to you.

Eating disorders

The transition from adolescence to adulthood is particularly risky for the development of anorexia nervosa (AN) and bulimia nervosa (BN). An estimated 0.9 per cent of young women aged 12 to 24 will develop AN, while about 1.5 per cent of young women develop BN. While young women are three times more likely to develop these disorders, young men in recent years are increasingly showing to have eating issues.

While our societal obsession with thinness may set the scene; genetic risk factors, as well as underlying anxiety, perfectionism and self-esteem issues are thought to combine to trigger the disorders.

Once anorexia starts and the body gets into starvation mode, the brain chemistry changes. As well, the body’s dehydration, altered electrolyte balance and poor nutritional status can lead to heart rhythm issues and other organ function problems.

The goal in treating anorexia is to re-feed the person to a healthier weight, and then treat the disordered thinking behind the condition, with one or more of the most effective treatments. These treatments include cognitive behavioural therapy (CBT), family-based therapy and dialectic behavior therapy (DBT). Re-feeding and psychotherapy may co-occur once the person is progressing to a healthier weight.

With bulimia, along with CBT, antidepressant medication has been shown to be helpful. In both conditions, medications may be helpful if there is a co-occurring mood or anxiety disorder, as is often the case.

Symptoms of anorexia to look for in your teen include rapid or significant weight loss, food restriction and obsession with calories or exercise. For bulimia, weight loss may not be very apparent, but your teen may go to the washroom immediately after eating and run the water. (You may see evidence of vomiting in the toilet bowl.)

Since anorexia has the highest mortality rate of any psychiatric illness, it is important to seek help at the first signs.

For more information and to see a full listing of provincial programs, including the Provincial Specialized Eating Disorders Program for Children and Adolescents at BC Children’s Hospital, as well for videos and other helpful information, see Kelty Eating Disorders, keltyeatingdisorders.ca. Another source for information is the National Eating Disorders Information Centre, nedic.ca.

Obsessive-Compulsive Disorder (OCD)

Obsessions are repetitive, intrusive and unwanted thoughts that cause the affected youth great anxiety. Compulsions are the actions or the rituals that he or she must go through to reduce the anxiety caused by the obsessive thoughts.

A very common OCD obsession is about contamination or germs, with the compulsion being the need to hand wash repeatedly or avoid any surface, individual or situation where germs might be present. Another common OCD obsession is the fear that something terrible will happen unless the youth takes a specific ritualistic action, like counting, checking, or placing items in a specific order.

Genetic risk factors plus an environmental trigger are thought to set off the illness, which tends to run in families. One environmental trigger that may be linked to sudden onset OCD symptoms in some susceptible children is a recent infection with Streptococcus A bacteria (Strep throat). This burgeoning, but controversial area of research may yield more insights in future years.

Treatment with antidepressant-types of medication plus exposure response prevention therapy – a specific form of cognitive behavioural therapy that features gradual exposure to the issue causing the obsessive thoughts and compulsions — has been shown to have success with some individuals. Left untreated, however, OCD can be very debilitating. The longer the OCD goes on, the harder it is to treat.

Again, if you are worried about possible signs of OCD in your child, see your family doctor or the Ministry of Children and Family Development CYMH clinic in your region. They may refer your child to specialized services, such as psychiatric services or the specialized OCD program at BC Children’s Hospital. For more information, see at ocdbc.ca, www.keltymentalhealth.ca or the OCD pages at cmha.ca.

**********

Dr. David Smith is an adolescent and adult psychiatrist and the medical director of the Okanagan Psychiatric services for Interior Health. This series of columns on common child and youth mental health issues is a project of the Child and Youth Mental Health and Substances Use Collaborative. The Collaborative involves multiple individuals, organizations and ministries all working together to increase the number of children, youth, and their families receiving timely access to mental health services and support in the Interior Health and Vancouver Island regions. The Collaborative is jointly funded by Doctors of BC and the government of B.C.

 

Just Posted

NorthIsle starts drilling in Pemberton Hills area after negotiating deal with Freeport

Mining industry one step closer to a revitalization after farm-out agreement

‘Police are ready’ for legal pot, say Canadian chiefs

But Canadians won’t see major policing changes as pot becomes legal

Port Hardy Fire Rescue’s open house a blazing hit

PHFR Lt. Harding explained that the organization is always looking for more recruits.

Gwa’sala-’Nakwaxda’xw Nation drafts first phase of passive housing project

The housing project will have 96 residential units for low-income families.

North Island Seniors Housing Foundation requests land from Port Hardy Council

“The foundation members will be coming to council with more information at a future date.”

Rick Mercer says pot is ‘excruciatingly boring’

Comedian hopes Canadians will move onto something else once marijuana is legalized

7 Mile Landfill operations tender closes October

Taxes covering the landfill have not increased over the past 15 years and are not expected to soon.

A B.C. campaign to give municipalities input into marijuana advertising

Without a say, towns and cities risk Washington-State-style flood of advertising, proponent says

Defence cautions against mob justice in Calgary child neglect trial

Jennifer and Jeromie Clark of Calgary have pleaded not guilty to criminal negligence causing death

Feds eyeing options to expedite pardons for minor pot convictions

Internal discussions have focused on an application-based process for speeding up pot pardons

Port Hardy municipal election candidate Janet Dorward’s profile

“My passion for Port Hardy is about ensuring the best standards of living,” Dorward said.

Port McNeill municipal election candidate Matt Martin’s profile

“I believe Port McNeill can become an even more vibrant and successful community,” said Martin.

Island pot smokers won’t be allowed to light up on the ski hill

Mount Washington maintains smoke-free policy in light of marijuana legalization

U.S. pot firms urge Trump to dominate North American marijuana industry

Cannabis producers claim the U.S. is “rapidly losing” its competitive advantage to Canada

Most Read