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

Kindergarten kids from Evans elementary school in Chilliwack painted rocks with orange hearts and delivered them to Sto:lo Elders Lodge recently after learning about residential schools. (Laura Bridge photo)
Kindergarten class paints rocks with orange hearts in Chilliwack for local elders

‘Compassion and empathy’ being shown by kids learning about residential schools

Chilliwack potter Cathy Terepocki (left) and Indigenous enhancement teachers Val Tosoff (striped top) and Christine Seymour (fuchsia coat), along with students at Vedder middle school, look at some of the 500-plus pinch pots on Thursday, June 10 made by the kids to honour the 215 children found at Kamloops Indian Residential School. (Jenna Hauck/ Chilliwack Progress)
Chilliwack students make hundreds of tiny clay pots in honour of 215 Indigenous children

‘I think the healing process has begun,’ says teacher about Vedder middle school project

Image by Free-Photos from Pixabay
Webinar looks at sexual abuse prevention among adolescents

Vancouver/Fraser Valley CoSA hosts free online session on June 15

Emergency services were on the scene of an apparent stabbing Friday afternoon (June 11) in the 2400 block of Countess Street in Abbotsford. (Photo: Kaytlin Harrison)
Two suspects arrested after apparent stabbing in Abbotsford

Incident occurs Friday afternoon in 2400 block of Countess Street

June is Brain Injury Awareness Month in Canada. (ADOBE STOCK IMAGE)
Shining a light on brain injury in Canada

June is Brain Injury Awareness Month

At an outdoor drive-in convocation ceremony, Mount Royal University bestows an honorary Doctor of Laws on Blackfoot Elder and residential school survivor Clarence Wolfleg in Calgary on Tuesday, June 8, 2021. THE CANADIAN PRESS/Jeff McIntosh
‘You didn’t get the best of me’: Residential school survivor gets honorary doctorate

Clarence Wolfleg receives honorary doctorate from Mount Royal University, the highest honour the school gives out

Two-year-old Ivy McLeod laughs while playing with Lucky the puppy outside their Chilliwack home on Thursday, June 10, 2021. (Jenna Hauck/ Chilliwack Progress)
VIDEO: B.C. family finds ‘perfect’ puppy with limb difference for 2-year-old Ivy

Ivy has special bond with Lucky the puppy who was also born with limb difference

A million-dollar ticket was sold to an individual in Vernon from the Lotto Max draw Friday, June 11, 2021. (Photo courtesy of BCLC)
Lottery ticket worth $1 million sold in Vernon

One lucky individual holds one of 20 tickets worth $1 million from Friday’s Lotto Max draw

“65 years, I’ve carried the stories in my mind and live it every day,” says Jack Kruger. (Athena Bonneau)
‘Maybe this time they will listen’: Survivor shares stories from B.C. residential school

Jack Kruger, living in Syilx territory, wasn’t surprised by news of 215 children’s remains found on the grounds of the former Kamloops Indian Residential School

A logging truck carries its load down the Elaho Valley near in Squamish, B.C. in this file photo. THE CANADIAN PRESS/Chuck Stoody
Squamish Nation calls for old-growth logging moratorium in its territory

The nation says 44% of old-growth forests in its 6,900-square kilometre territory are protected while the rest remain at risk

Flowers and cards are left at a makeshift memorial at a monument outside the former Kamloops Indian Residential School to honour the 215 children whose remains are believed to have been discovered buried near the city in Kamloops, B.C., on Monday, May 31, 2021. THE CANADIAN PRESS/Darryl Dyck
‘Pick a Sunday:’ Indigenous leaders ask Catholics to stay home, push for apology

Indigenous leaders are calling on Catholics to stand in solidarity with residential school survivors by not attending church services

“They will never be forgotten, every child matters,” says Sioux Valley Chief Jennifer Bone in a video statement June 1. (Screen grab)
104 ‘potential graves’ detected at site of former residential school in Manitoba

Sioux Valley Dakota Nation working to identify, repatriate students buried near former Brandon residential school

The Queen Victoria statue at the B.C. legislature was splattered with what looks like red paint on Friday. (Nicole Crescenzi/News Staff)
Queen Victoria statue at B.C. legislature vandalized Friday

Statue splattered with red paint by old growth forest proponents

Most Read