May 28, 2025 • 25 mins
Quincy is joined by Dr. Latoya Lee, Board Certified as a Family Psychiatric Mental Health Nurse Practitioner, to discuss anxiety and OCD in adolescents. Listen in to learn about the symptoms of anxiety and OCD in kids and what you can do as a parent to help manage and treat those symptoms. Have you heard of the 333 Rule? Give it a try with your kiddo after listening to this week's episode!
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Episode Transcript
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UNKNOWN (00:00):
🎵🎵
SPEAKER_00 (00:09):
Welcome back.
This podcast is a communityhealth initiative brought to you
by Frontier Nursing Universityand the Woodford County Chamber
of Commerce to improve communityhealth and increase healthcare
awareness.
In today's episode, we aretalking about anxiety and OCD in
children, particularly youngchildren, with Dr.
LaToya Lee.
(00:30):
Dr.
Lee is a board-certified familypsychiatric mental health nurse
practitioner.
She earned her doctoral degreefrom the University of Kentucky
in 2017.
She is a member of the AmericanNurses Association and the
American Psychiatric NursesAssociation.
Dr.
Lee practices here in Kentuckyand takes a holistic whole body
(00:51):
approach to medicationmanagement.
She helps patients acrossvarious age groups, including
adolescents, young adults, andseniors find balance and relief
from mental health challengesthrough compassionate and
personalized care.
Dr.
Lee, thank you so much forjoining me today.
Can you tell me a little bitabout your background before we
get started?
SPEAKER_01 (01:11):
Yes, so as she said, I earned my doctorate degree at
the University of Kentucky.
It was a DNP program, and it wasa BSN to DNP, and I did I did it
part time.
It took me five years.
And before that, I also have adegree from the University of
Louisville in psychology.
(01:32):
I started working at a psychhospital in Louisville.
Louisville and I saw a psychnurse practitioner and at first
I thought I wanted to be atherapist and once I saw her I
fell in love it was a therapyplus medicine married together
and it was a one month before mygraduation with my bachelors of
(01:55):
psychology degree and I calledmy dad and I said I know what I
want to be when I grow up and hesaid what and I said I don't
want to do therapy anymore I'mgoing to He said, well, you're
going to graduate in a month.
So I don't know what you'regoing to do.
So I looked it up and theUniversity of Kentucky had a BSN
(02:17):
program and that then you couldbridge into a nurse practitioner
position.
So I was like, I'm going to goback to school.
And he said, again, you're goingto graduate in a month.
And how that's going to happenis going to be up to you.
So I like to call myself aprofessional student.
Right.
We're continuing to learn everyday.
SPEAKER_00 (02:39):
Okay, so we recently were talking and I asked you
what you're seeing more of inpractice with kids.
And you mentioned OCD andanxiety.
And so that's what reallysparked this episode.
So tell me about that.
What is OCD?
What's anxiety?
And how is it presenting inthese younger kids?
SPEAKER_01 (03:00):
Yes.
So anxiety, it's fairly commonin children.
Right now, it affects about 15to 20% of children and
adolescents.
It is more common in femalechildren more than males, but in
males it presents a little bitdifferent.
(03:20):
So commonly when you seesomebody with anxiety, it's it's
the classic case is excessiveworry or fear or.
They're very clingy.
They're dependent on mom or dador whoever their safety person
is.
But for boys, it can be moreirritability, anger, a little
(03:41):
bit more tantrums, withdrawals,meltdowns, as you see.
And both of them, they're goingto avoid behaviors because that
behavior or whatever they'reavoiding is what's causing some
of their anxiety.
Mind you, if that's a socialsetting, grocery store, a lot of
times what I am seeing right nowis kids going back to school.
(04:05):
And I think that that stems fromCOVID and where they were out of
school for about a year.
And a lot of them, were at homein their safety place and
transitioning to go back toschool has been difficult for
those clients or patients that Ihave that have anxiety.
SPEAKER_00 (04:27):
Okay, so before we move on to OCD and what that is,
you mentioned some symptoms ofanxiety being clingy, dependent
on a parent, and even like themeltdowns for the boys.
UNKNOWN (04:42):
Yeah.
SPEAKER_00 (04:42):
what, what age group are we talking about now?
Because it also, I know what'sage appropriate.
And so identifying that beforesaying, Oh my gosh, my one year
old has anxiety, but really, Imean, that's an age appropriate
behavior.
SPEAKER_01 (04:56):
So, so if you're talking about somebody that is a
little bit more clingy anddependent, you're going to see
that in young children, but it'svery excessive because usually
you'll see, um, a young childthat's five to, let's say, nine.
They're gonna be a little bitmore clingy, but once they get
comfortable, They let go.
(05:17):
They loosen up.
And if you can't even go to thegrocery store or do all these
things and they're just likeglued to your leg and it's all
the time, you're going to belike, hmm, what's really going
on here?
Okay.
And then they're also, they'llstart to have those tantrums
where they don't want to get outof the car.
They don't want to go inside.
(05:37):
They start to cover up theirface when people talk to them.
That's what you're going to seein that younger group.
For the older group that morethat non to 220 it's going to be
more of that withdrawal I don'twant to go to the store with you
mom why you don't want to go tothe store yeah there's too many
people in the store so that'sthat avoidance that's that
(05:59):
withdrawal and then when theyget there they're just mean to
everybody because they don'tknow how to express that yeah
and especially for boys you knowbecause you know they already
got a little bit of thattestosterone at that age and so
they're going to be a little bitmore irritable they're going to
be a with you um and so that'sthat's kind of the difference
(06:21):
but it's when it starts messingwith the function of their daily
life and it's a consistentproblem all the time you have to
start thinking is this more thannormal
SPEAKER_00 (06:32):
right okay so when it's disrupt causing a
disruption yes
SPEAKER_01 (06:35):
and so and that's the same thing with them
avoiding school they don't wantto get out of the car And then
that's when you will start tonot just see the emotional
behavior, you start seeing thephysical symptoms of the
anxiety.
I have a stomachache.
My stomach hurts.
(06:56):
And you're like, why does yourstomach hurt every day right
when it's time to go to school?
Right.
And they know if they have astomachache and they're sick,
they don't have to go.
And so you'll see a lot of thatis they have a lot more sick
days than normal.
But when you let them go home,magically the stomachaches go
(07:16):
away.
Yes.
And I don't need no Sprite, Mom,or ginger ale.
I don't need to go to thedoctor.
I just don't need to go toschool.
And then when it starts to spillinto school, that's when you're
going to start getting a lot ofthe calls from teachers from the
teachers because again that'swhen you're going to say oh
little Johnny's not reallyconcentrating very well it's
(07:39):
because they're anxious they'rehaving a lot of anxious thoughts
they're worried about theirpeers looking at them they're
worried about if they lookdifferent they're worried about
if they don't know the answer tothe question yeah and so they're
not concentrating very well andthen they're not again avoiding
they're avoiding their otherpeers they only want to play
with one person if they can'tplay with that one person they
(08:01):
have meltdowns at school schoolso you really have to if they're
that school age try to get theteachers involvement okay so
SPEAKER_00 (08:10):
that's the anxiety side of it yeah and what is OCD
in children and what does thatlook like
SPEAKER_01 (08:17):
anxiety and OCD kind of go hand to hand they're kind
of go together so OCD orobsession compulsive disorder
they're going to have more ofthose obsessive thoughts and you
know they it's the worry butit's like on 10 so they're
always you know they get onething in their head and they
(08:39):
can't get it out and so they'rejust always worried about this
and this and this but what ifthis and what if this doesn't
happen and and then you're alsoyou especially when they come to
see me, I'm going to ask them,where do those thoughts go?
What happens with thosethoughts?
And so they start to think, if Idon't do X, Y, and Z, then
(09:00):
something bad will happen.
OCD in children can also looklike they have to have a very
strategic routine every day.
And if they deviate from thatroutine, they have meltdowns.
They have a breakdown.
They have a very specificnighttime routine and if they
(09:22):
don't get to do all those stepsthey make you do it all the way
over and
SPEAKER_00 (09:27):
is it because does it stem from feeling that
something is going to go wrongif you're not following that yes
SPEAKER_01 (09:34):
very much and they want to be in control because if
you're in control of thesituation you know what to
anticipate next okay and youwon't have that anxiety of what
what's going to happen becauseyou are in control and you know
what's supposed to happen.
So anxiety
SPEAKER_00 (09:48):
is a symptom of OCD.
SPEAKER_01 (09:50):
It coincides together because there's
different types.
You can, you can have the onesthat like to count a lot.
You got the, the normal onesthat you kind of see on TV, the
hand washing, you see that inkids.
And it's again, that controlsituation and, and they're
germaphobic.
And when they take thatgermaphobic to the next level
(10:11):
and their hands start to turnred and, and, and things like
that, you're going to think, isthis more of a OCD compulsive
behaviors?
SPEAKER_00 (10:20):
Okay.
Yeah.
So it's, it's not that, Oh, Idon't like germs, but it's
whenever it goes to the nextlevel, that's OCD.
Yep.
SPEAKER_01 (10:27):
And so, and, and then they can feed off each
other.
You know, you know, I haveanxiety because I don't get to
do my routines or I do myroutines and it still causes me
anxiety type deal.
Um, right now they're doing alot of research on, um, on
autoimmune type responses.
It's called PANDAS and itcoincides with strep throat.
(10:52):
And so if you get a lot of strepthroat infections, they think
it's causing some kind ofautoimmune and you're more
predisposed to have OCD andanxiety.
We don't know why.
They're still doing research.
But I have those patients thatare coming in, and that's one of
the number one questions I askwhen the parents are saying
(11:13):
they're having this, they'rehaving this.
And then I say, have they had alot of history of strep throat?
And if that's the case, then Iknow that we're already on that
path for the OCD, for theanxiety.
How
SPEAKER_00 (11:26):
do you get tested for
SPEAKER_01 (11:26):
that?
There's no real test.
And here in Kentucky, I have tosend them to the University of
Cincinnati.
And they have a whole specialtyclinic on that.
And when they have flare-ups,the OCD gets worse.
The anxiety gets worse.
(11:47):
So that's why they're talkingabout it.
it's an autoimmune somethinggotcha so and and they you will
just see like if they get sickthat stressor and then the ocd
the anxiety gets a little bitworse
SPEAKER_00 (12:00):
so whenever they're not sick or not having a
flare-up then it's not as badbut it's still there very much
very much that's superinteresting and it's just
fascinating like how far we'vecome with research and what we
know now and what we're going toknow in like 10 to 20 years on
something like this.
SPEAKER_01 (12:18):
Yes.
Yes.
Even, even if, if we're gettingoff subject, but if I have
adults with anxiety or OCD, youknow, I asked them, did you have
a lot of strep throat as a kid?
More than 90% most of the timesay, yes, I did.
That's funny.
Why did you ask that?
And then I tell them that andthey're like, Oh yeah, But it's
(12:41):
one of my questions on an intakealways.
Wow.
SPEAKER_00 (12:45):
That's fascinating.
Okay.
So how are parents identifyingthis?
You kind of ran through some ofthem.
SPEAKER_01 (12:54):
Sometimes it's the school.
A lot of times the school aresaying, you know...
This isn't going to work.
Something's going on.
But then the parents, especiallyif we're talking about OCD and
routines, it's interruptingtheir daily function.
So then they're like, what am Isupposed to do?
What am I supposed to do?
(13:15):
And then if it's anxiety and youcan't go where you need to go,
you can't move the way you needto move and they're declining
socially because they're just soenclosed and fearful to do new
things.
Then that's when you'll you willeventually see those patients in
my clinic.
(13:35):
Now,
SPEAKER_00 (13:37):
if I'm a parent and I am seeing some changes in my
seven-year-old, and I'm assumingI'm probably going to get a
referral from my primary orpediatrician to come and see
you, how do I prepare my kid tocome and see you?
SPEAKER_01 (13:55):
I like to tell them that, just tell them that we're
just going to go to a normalclinic to a normal doctor's
visit.
Make sure there's no shotsinvolved.
Because that's the number onething.
You can tell they have anxietyand they're very apprehensive
when I call their name and don'twant to come.
That's exactly what I say rightup front.
(14:17):
There's no shots.
And they're like, there's noshots?
Yeah.
I said, come on, I got toys.
Kind of a little bit of thatstranger danger, but I'm a nice
stranger.
But I'm like, I got toys.
I got candy.
Yeah.
Shouldn't do that, but
SPEAKER_00 (14:32):
that's what works.
And what does the visit looklike for the kids?
SPEAKER_01 (14:39):
So right up front, I tell them, I try to sometimes
get on their level and talk tothem.
And I said, I just have a lot ofquestions I'm going to ask you.
I'm going to have some questionsto talk to mom about.
And then we're going to come upwith a plan afterwards of how we
can get you feeling better.
And so I tell them it's going tobe like 60 minutes, but after I
(15:01):
get my questions, you're morethan welcome to play with my box
of toys and things like that.
And so I ask parents before theycome, they have a form that they
need to fill out of all thequestions.
And I want to know from uterotill now, how did we get there?
(15:21):
And so I want to know aboutbirth history.
I want to know about familypsych history.
I want to know how they were asa baby.
And then when do these symptomsstart what makes them worse what
makes them better and then againas you said I like that holistic
approach so I want to know howthey're eating sleeping because
(15:42):
that's very much a big component
SPEAKER_00 (15:44):
right and so you mentioned family psych history
how closely is that related
SPEAKER_01 (15:49):
it is very related and and so when you start
talking to people you you'll seethere has to be a genetic
component when everybody youknow grandma great-grandma And
mom has anxiety.
So there we are.
OCD is the same way.
There's usually some kind offamily member, one or two, that
(16:11):
has OCD.
And then that's also a trickything.
So if you live with a parentthat has OCD, you might pick up
on some of those behaviors.
Okay, I was wondering that.
SPEAKER_00 (16:21):
And so for you, is that kind of like...
working to kind of treat thewhole family.
Like if you're seeing a mom, Isee family groups.
SPEAKER_01 (16:28):
Yeah.
Okay.
Okay.
Cause what happens is, is mombrings, you know, little Mary in
there and she's like, you knowwhat?
A lot of this resonates with me.
Can I come see you too?
And so then I'm seeing mom andthen, you know, I'm seeing
grandma and, and things likethat.
SPEAKER_00 (16:47):
Well, and I feel like if you're treating the
kiddo and mom is still doingthose behaviors, it's just, And
SPEAKER_01 (16:54):
so that's what you come with kids.
Sometimes you have to treat theparents with the kids because we
have to figure out what's goingon at home or if there's a
parenting thing or somethingthat we need to work on too.
SPEAKER_00 (17:08):
Right.
SPEAKER_01 (17:09):
So
SPEAKER_00 (17:10):
this might be an absolute silly question, but are
there any preventative actionswe can take?
I mean, perhaps...
looking at yourself as a parent,like, am I doing something too?
SPEAKER_01 (17:21):
Yes.
So if you have anxiety, if youhave OCD, you need to take care
of yourself because your kidsfeel that, you know, and that's
something that I, even when Ihave pregnant patients, what
your kid or baby needs is ahappy mom or dad.
Right.
Because everything that your kidlearns is from you.
That's, that's your whole job.
(17:42):
Your whole job is to, to teachthis kid how to be a successful
mom.
whatever that would be, loving,caring an adult.
That's what your job is when youhave that kid.
And so they learn from yourbehaviors.
And so if you're not mentallyhealthy, how do you expect the
kid to be mentally healthy?
SPEAKER_00 (18:04):
Right.
So one more question on this.
What are some strategies ormethods of coping?
So we get a diagnosis that mykid is anxious or has OCD.
What are some things that we cando at home?
SPEAKER_01 (18:21):
Okay.
SPEAKER_00 (18:23):
Are we talking about non-medicines?
Well, actually, not lastquestion.
So in addition to, I guess, thetreatment, let's go to there
SPEAKER_01 (18:33):
first.
So a lot of parents are like, Idon't want to put my kids on
medicine.
Yeah, I don't either.
But if it's extreme, that'sprobably where we'll go if we're
not, again, functioning.
First, we're going to dotherapy.
And can we do some therapy?
The best type of therapy wouldbe CBT, which is cognitive
behavioral therapy, it givesthem the techniques of what
(18:56):
happens when I am anxious.
You know, how to retrain thebrain at that point.
There's a grounding technique Imodify for kids, but it's called
3-3-3.
You have the kids to sit downand identify three different
things that they see.
Identify three different thingsthat they hear.
(19:20):
three different things that theycan feel that's going to help
them get back in the presentinstead of that anxious mind.
SPEAKER_00 (19:28):
Um, for adults, five, five, five.
SPEAKER_01 (19:29):
Yes.
SPEAKER_00 (19:30):
Okay.
For
SPEAKER_01 (19:31):
adults, it's five, five, five.
Okay.
And so you're, you know, you'regrounding yourself and, you
know, putting your feet on thefloor and then you're using more
of the five senses.
What can I hear?
What can I smell?
What can I taste?
What can I touch?
What do I see?
Okay.
And so then that kind of, okay,calm and, It's never too early
(19:52):
to teach them breathingtechniques.
Take a deep breath, hold it,take another deep breath.
That's the best thing for anykind of tantrums.
And then I also want them to geton eye level with your kid and
say, you're okay, I'm okay.
Kind of Tell me what's going on,what you're feeling, and what
(20:14):
has triggered this.
How can I help you work throughthis?
Because you don't want to be Ineed to save them because what's
going to happen when you have togo to work?
What's going to happen when theyhave to be at school?
What's going to happen atgrandma's house?
They have to learn thetechniques on how to self-soothe
and cope their self.
(20:34):
And that's exactly what thetherapist is going to do.
There's CBT for kids.
There's play therapy with theCBT.
Highly recommend it.
Here in Kentucky, we have equinetherapy.
And you can go in and do thingswith it.
the horses it's highlyrecommended yeah
SPEAKER_00 (20:53):
so okay so lots of treatment options yes and and we
don't have to just jump tomedicine we
SPEAKER_01 (20:59):
do not have to jump to medicine unless we feel like
it's some kind of very specificlike we're having anxiety
attacks and extreme phobias youknow we can't
SPEAKER_00 (21:13):
do what we need to do.
Is it something where if we haveto go to medicine, is it
something that they're on forlife or is there ways that we
can treat with medicine now andthen work on strategies to wean
off of that?
It's
SPEAKER_01 (21:26):
always your goal to get to some kind of remission.
So hopefully, no, it's not along-term medicine that you'll
have to be on for life.
But if we're talking aboutgenetics, you know, genetics is
genetics.
If everybody in your family hasanxiety, but the best thing is
if you're going to catch itearly we can give them those
coping skills or tools in theirtoolboxes i say that they can
(21:50):
use so maybe we don't need asmuch as medicine or um we can
eventually get off medicinesright
SPEAKER_00 (21:57):
yeah yeah i think that's i feel like that's
probably the goal for a lot ofparents
SPEAKER_01 (22:01):
it is it is you know it is mind altering medicines
but if we're talking about agenetic thing that's just you
know if if we were talking aboutyour heart right and you need
this medicine to live, wewouldn't be having any
questions.
But for the stigma of mentalhealth, you know, they're like,
oh, but this is exactly what Itell all my patients is your
(22:23):
brain is one of your biggestorgans.
If your brain's not functioning,how's everything else going to
function?
Right.
So if, like I said, if we'retalking about your heart, you'd
be like, give me all the pills.
If it's your brain, you stillneed that because your brain is
telling your heart what to do,what your lungs have to do and
everything else.
And so I think it's just gettingaway from that stigma of mental
(22:46):
health.
SPEAKER_00 (22:47):
And then what can we do at home?
Which I think you mentioned the333.
Yes.
And then
SPEAKER_01 (22:52):
also what we really can do at home is we need to
work on our diets and sleep.
So sleep and anxiety go hand inhand.
So that's one of the questionsthat I ask.
How well are they sleeping?
Are we having nightmares?
Are they sleeping throughout thenight?
Do they have a good bedtime?
Kids need sleep.
They do not need to be up atnight.
(23:14):
They need a routine.
So what is their routine?
They need to be, you know, youngkids needed to be in a bed by 8
8 30 they need all the sleepthey can get them teenagers they
need all the sleep they can getbecause they don't like to wake
up early in the morning but ifyou can get your sleep regulated
it's kind of like a reset andand so I do a lot of sleep
(23:36):
hygiene weighted blankets aregreat for anxiety also mood and
attention and concentration so Ihighly recommend that but food
food is my newest biggest kick Ion things.
If we don't have a clear gut,those toxins are going to cloudy
up your brain.
You're going to have more mentalhealth symptoms.
(23:57):
So if we're not eating goodfoods, if little Johnny's eating
McDonald's three times a day, weneed to get a more well-balanced
diet.
So I'm a big component onvitamins if we're not getting a
good balance, because it's hardto get kids to eat certain
things.
But we do need our fruits andvegetables.
(24:17):
All right.
Any last thoughts?
No.
I mean, just be there for yourkids.
Ask them the questions that theyneed to know.
Really, you know, take intoaccount what the teacher has to
say and know that there'sseveral different options.
It's not just all aboutmedicine.
It might be that we just need todo some modifications at home
(24:41):
and with behaviors.
And...
we're going to improve on thesekids' mental health one day at a
time.
Yeah.
And it'll make a
SPEAKER_00 (24:49):
difference for their
SPEAKER_01 (24:50):
life.
It will.
It will.
And that way, you can reallycatch it early before it...
gets worse later on in life.
SPEAKER_00 (25:00):
Well, thank you so much for joining me today.
Thank
SPEAKER_01 (25:02):
you.
SPEAKER_00 (25:03):
We'll see you all next time.
This podcast is brought to youby Frontier Nursing University
and the Woodford County Chamberof Commerce and is part of the
What's Up Woodford Network.
🎵🎵
SPEAKER_00 (00:09):
Welcome back.
This podcast is a communityhealth initiative brought to you
by Frontier Nursing Universityand the Woodford County Chamber
of Commerce to improve communityhealth and increase healthcare
awareness.
In today's episode, we aretalking about anxiety and OCD in
children, particularly youngchildren, with Dr.
LaToya Lee.
(00:30):
Dr.
Lee is a board-certified familypsychiatric mental health nurse
practitioner.
She earned her doctoral degreefrom the University of Kentucky
in 2017.
She is a member of the AmericanNurses Association and the
American Psychiatric NursesAssociation.
Dr.
Lee practices here in Kentuckyand takes a holistic whole body
(00:51):
approach to medicationmanagement.
She helps patients acrossvarious age groups, including
adolescents, young adults, andseniors find balance and relief
from mental health challengesthrough compassionate and
personalized care.
Dr.
Lee, thank you so much forjoining me today.
Can you tell me a little bitabout your background before we
get started?
SPEAKER_01 (01:11):
Yes, so as she said, I earned my doctorate degree at
the University of Kentucky.
It was a DNP program, and it wasa BSN to DNP, and I did I did it
part time.
It took me five years.
And before that, I also have adegree from the University of
Louisville in psychology.
(01:32):
I started working at a psychhospital in Louisville.
Louisville and I saw a psychnurse practitioner and at first
I thought I wanted to be atherapist and once I saw her I
fell in love it was a therapyplus medicine married together
and it was a one month before mygraduation with my bachelors of
(01:55):
psychology degree and I calledmy dad and I said I know what I
want to be when I grow up and hesaid what and I said I don't
want to do therapy anymore I'mgoing to He said, well, you're
going to graduate in a month.
So I don't know what you'regoing to do.
So I looked it up and theUniversity of Kentucky had a BSN
(02:17):
program and that then you couldbridge into a nurse practitioner
position.
So I was like, I'm going to goback to school.
And he said, again, you're goingto graduate in a month.
And how that's going to happenis going to be up to you.
So I like to call myself aprofessional student.
Right.
We're continuing to learn everyday.
SPEAKER_00 (02:39):
Okay, so we recently were talking and I asked you
what you're seeing more of inpractice with kids.
And you mentioned OCD andanxiety.
And so that's what reallysparked this episode.
So tell me about that.
What is OCD?
What's anxiety?
And how is it presenting inthese younger kids?
SPEAKER_01 (03:00):
Yes.
So anxiety, it's fairly commonin children.
Right now, it affects about 15to 20% of children and
adolescents.
It is more common in femalechildren more than males, but in
males it presents a little bitdifferent.
(03:20):
So commonly when you seesomebody with anxiety, it's it's
the classic case is excessiveworry or fear or.
They're very clingy.
They're dependent on mom or dador whoever their safety person
is.
But for boys, it can be moreirritability, anger, a little
(03:41):
bit more tantrums, withdrawals,meltdowns, as you see.
And both of them, they're goingto avoid behaviors because that
behavior or whatever they'reavoiding is what's causing some
of their anxiety.
Mind you, if that's a socialsetting, grocery store, a lot of
times what I am seeing right nowis kids going back to school.
(04:05):
And I think that that stems fromCOVID and where they were out of
school for about a year.
And a lot of them, were at homein their safety place and
transitioning to go back toschool has been difficult for
those clients or patients that Ihave that have anxiety.
SPEAKER_00 (04:27):
Okay, so before we move on to OCD and what that is,
you mentioned some symptoms ofanxiety being clingy, dependent
on a parent, and even like themeltdowns for the boys.
UNKNOWN (04:42):
Yeah.
SPEAKER_00 (04:42):
what, what age group are we talking about now?
Because it also, I know what'sage appropriate.
And so identifying that beforesaying, Oh my gosh, my one year
old has anxiety, but really, Imean, that's an age appropriate
behavior.
SPEAKER_01 (04:56):
So, so if you're talking about somebody that is a
little bit more clingy anddependent, you're going to see
that in young children, but it'svery excessive because usually
you'll see, um, a young childthat's five to, let's say, nine.
They're gonna be a little bitmore clingy, but once they get
comfortable, They let go.
(05:17):
They loosen up.
And if you can't even go to thegrocery store or do all these
things and they're just likeglued to your leg and it's all
the time, you're going to belike, hmm, what's really going
on here?
Okay.
And then they're also, they'llstart to have those tantrums
where they don't want to get outof the car.
They don't want to go inside.
(05:37):
They start to cover up theirface when people talk to them.
That's what you're going to seein that younger group.
For the older group that morethat non to 220 it's going to be
more of that withdrawal I don'twant to go to the store with you
mom why you don't want to go tothe store yeah there's too many
people in the store so that'sthat avoidance that's that
(05:59):
withdrawal and then when theyget there they're just mean to
everybody because they don'tknow how to express that yeah
and especially for boys you knowbecause you know they already
got a little bit of thattestosterone at that age and so
they're going to be a little bitmore irritable they're going to
be a with you um and so that'sthat's kind of the difference
(06:21):
but it's when it starts messingwith the function of their daily
life and it's a consistentproblem all the time you have to
start thinking is this more thannormal
SPEAKER_00 (06:32):
right okay so when it's disrupt causing a
disruption yes
SPEAKER_01 (06:35):
and so and that's the same thing with them
avoiding school they don't wantto get out of the car And then
that's when you will start tonot just see the emotional
behavior, you start seeing thephysical symptoms of the
anxiety.
I have a stomachache.
My stomach hurts.
(06:56):
And you're like, why does yourstomach hurt every day right
when it's time to go to school?
Right.
And they know if they have astomachache and they're sick,
they don't have to go.
And so you'll see a lot of thatis they have a lot more sick
days than normal.
But when you let them go home,magically the stomachaches go
(07:16):
away.
Yes.
And I don't need no Sprite, Mom,or ginger ale.
I don't need to go to thedoctor.
I just don't need to go toschool.
And then when it starts to spillinto school, that's when you're
going to start getting a lot ofthe calls from teachers from the
teachers because again that'swhen you're going to say oh
little Johnny's not reallyconcentrating very well it's
(07:39):
because they're anxious they'rehaving a lot of anxious thoughts
they're worried about theirpeers looking at them they're
worried about if they lookdifferent they're worried about
if they don't know the answer tothe question yeah and so they're
not concentrating very well andthen they're not again avoiding
they're avoiding their otherpeers they only want to play
with one person if they can'tplay with that one person they
(08:01):
have meltdowns at school schoolso you really have to if they're
that school age try to get theteachers involvement okay so
SPEAKER_00 (08:10):
that's the anxiety side of it yeah and what is OCD
in children and what does thatlook like
SPEAKER_01 (08:17):
anxiety and OCD kind of go hand to hand they're kind
of go together so OCD orobsession compulsive disorder
they're going to have more ofthose obsessive thoughts and you
know they it's the worry butit's like on 10 so they're
always you know they get onething in their head and they
(08:39):
can't get it out and so they'rejust always worried about this
and this and this but what ifthis and what if this doesn't
happen and and then you're alsoyou especially when they come to
see me, I'm going to ask them,where do those thoughts go?
What happens with thosethoughts?
And so they start to think, if Idon't do X, Y, and Z, then
(09:00):
something bad will happen.
OCD in children can also looklike they have to have a very
strategic routine every day.
And if they deviate from thatroutine, they have meltdowns.
They have a breakdown.
They have a very specificnighttime routine and if they
(09:22):
don't get to do all those stepsthey make you do it all the way
over and
SPEAKER_00 (09:27):
is it because does it stem from feeling that
something is going to go wrongif you're not following that yes
SPEAKER_01 (09:34):
very much and they want to be in control because if
you're in control of thesituation you know what to
anticipate next okay and youwon't have that anxiety of what
what's going to happen becauseyou are in control and you know
what's supposed to happen.
So anxiety
SPEAKER_00 (09:48):
is a symptom of OCD.
SPEAKER_01 (09:50):
It coincides together because there's
different types.
You can, you can have the onesthat like to count a lot.
You got the, the normal onesthat you kind of see on TV, the
hand washing, you see that inkids.
And it's again, that controlsituation and, and they're
germaphobic.
And when they take thatgermaphobic to the next level
(10:11):
and their hands start to turnred and, and, and things like
that, you're going to think, isthis more of a OCD compulsive
behaviors?
SPEAKER_00 (10:20):
Okay.
Yeah.
So it's, it's not that, Oh, Idon't like germs, but it's
whenever it goes to the nextlevel, that's OCD.
Yep.
SPEAKER_01 (10:27):
And so, and, and then they can feed off each
other.
You know, you know, I haveanxiety because I don't get to
do my routines or I do myroutines and it still causes me
anxiety type deal.
Um, right now they're doing alot of research on, um, on
autoimmune type responses.
It's called PANDAS and itcoincides with strep throat.
(10:52):
And so if you get a lot of strepthroat infections, they think
it's causing some kind ofautoimmune and you're more
predisposed to have OCD andanxiety.
We don't know why.
They're still doing research.
But I have those patients thatare coming in, and that's one of
the number one questions I askwhen the parents are saying
(11:13):
they're having this, they'rehaving this.
And then I say, have they had alot of history of strep throat?
And if that's the case, then Iknow that we're already on that
path for the OCD, for theanxiety.
How
SPEAKER_00 (11:26):
do you get tested for
SPEAKER_01 (11:26):
that?
There's no real test.
And here in Kentucky, I have tosend them to the University of
Cincinnati.
And they have a whole specialtyclinic on that.
And when they have flare-ups,the OCD gets worse.
The anxiety gets worse.
(11:47):
So that's why they're talkingabout it.
it's an autoimmune somethinggotcha so and and they you will
just see like if they get sickthat stressor and then the ocd
the anxiety gets a little bitworse
SPEAKER_00 (12:00):
so whenever they're not sick or not having a
flare-up then it's not as badbut it's still there very much
very much that's superinteresting and it's just
fascinating like how far we'vecome with research and what we
know now and what we're going toknow in like 10 to 20 years on
something like this.
SPEAKER_01 (12:18):
Yes.
Yes.
Even, even if, if we're gettingoff subject, but if I have
adults with anxiety or OCD, youknow, I asked them, did you have
a lot of strep throat as a kid?
More than 90% most of the timesay, yes, I did.
That's funny.
Why did you ask that?
And then I tell them that andthey're like, Oh yeah, But it's
(12:41):
one of my questions on an intakealways.
Wow.
SPEAKER_00 (12:45):
That's fascinating.
Okay.
So how are parents identifyingthis?
You kind of ran through some ofthem.
SPEAKER_01 (12:54):
Sometimes it's the school.
A lot of times the school aresaying, you know...
This isn't going to work.
Something's going on.
But then the parents, especiallyif we're talking about OCD and
routines, it's interruptingtheir daily function.
So then they're like, what am Isupposed to do?
What am I supposed to do?
(13:15):
And then if it's anxiety and youcan't go where you need to go,
you can't move the way you needto move and they're declining
socially because they're just soenclosed and fearful to do new
things.
Then that's when you'll you willeventually see those patients in
my clinic.
(13:35):
Now,
SPEAKER_00 (13:37):
if I'm a parent and I am seeing some changes in my
seven-year-old, and I'm assumingI'm probably going to get a
referral from my primary orpediatrician to come and see
you, how do I prepare my kid tocome and see you?
SPEAKER_01 (13:55):
I like to tell them that, just tell them that we're
just going to go to a normalclinic to a normal doctor's
visit.
Make sure there's no shotsinvolved.
Because that's the number onething.
You can tell they have anxietyand they're very apprehensive
when I call their name and don'twant to come.
That's exactly what I say rightup front.
(14:17):
There's no shots.
And they're like, there's noshots?
Yeah.
I said, come on, I got toys.
Kind of a little bit of thatstranger danger, but I'm a nice
stranger.
But I'm like, I got toys.
I got candy.
Yeah.
Shouldn't do that, but
SPEAKER_00 (14:32):
that's what works.
And what does the visit looklike for the kids?
SPEAKER_01 (14:39):
So right up front, I tell them, I try to sometimes
get on their level and talk tothem.
And I said, I just have a lot ofquestions I'm going to ask you.
I'm going to have some questionsto talk to mom about.
And then we're going to come upwith a plan afterwards of how we
can get you feeling better.
And so I tell them it's going tobe like 60 minutes, but after I
(15:01):
get my questions, you're morethan welcome to play with my box
of toys and things like that.
And so I ask parents before theycome, they have a form that they
need to fill out of all thequestions.
And I want to know from uterotill now, how did we get there?
(15:21):
And so I want to know aboutbirth history.
I want to know about familypsych history.
I want to know how they were asa baby.
And then when do these symptomsstart what makes them worse what
makes them better and then againas you said I like that holistic
approach so I want to know howthey're eating sleeping because
(15:42):
that's very much a big component
SPEAKER_00 (15:44):
right and so you mentioned family psych history
how closely is that related
SPEAKER_01 (15:49):
it is very related and and so when you start
talking to people you you'll seethere has to be a genetic
component when everybody youknow grandma great-grandma And
mom has anxiety.
So there we are.
OCD is the same way.
There's usually some kind offamily member, one or two, that
(16:11):
has OCD.
And then that's also a trickything.
So if you live with a parentthat has OCD, you might pick up
on some of those behaviors.
Okay, I was wondering that.
SPEAKER_00 (16:21):
And so for you, is that kind of like...
working to kind of treat thewhole family.
Like if you're seeing a mom, Isee family groups.
SPEAKER_01 (16:28):
Yeah.
Okay.
Okay.
Cause what happens is, is mombrings, you know, little Mary in
there and she's like, you knowwhat?
A lot of this resonates with me.
Can I come see you too?
And so then I'm seeing mom andthen, you know, I'm seeing
grandma and, and things likethat.
SPEAKER_00 (16:47):
Well, and I feel like if you're treating the
kiddo and mom is still doingthose behaviors, it's just, And
SPEAKER_01 (16:54):
so that's what you come with kids.
Sometimes you have to treat theparents with the kids because we
have to figure out what's goingon at home or if there's a
parenting thing or somethingthat we need to work on too.
SPEAKER_00 (17:08):
Right.
SPEAKER_01 (17:09):
So
SPEAKER_00 (17:10):
this might be an absolute silly question, but are
there any preventative actionswe can take?
I mean, perhaps...
looking at yourself as a parent,like, am I doing something too?
SPEAKER_01 (17:21):
Yes.
So if you have anxiety, if youhave OCD, you need to take care
of yourself because your kidsfeel that, you know, and that's
something that I, even when Ihave pregnant patients, what
your kid or baby needs is ahappy mom or dad.
Right.
Because everything that your kidlearns is from you.
That's, that's your whole job.
(17:42):
Your whole job is to, to teachthis kid how to be a successful
mom.
whatever that would be, loving,caring an adult.
That's what your job is when youhave that kid.
And so they learn from yourbehaviors.
And so if you're not mentallyhealthy, how do you expect the
kid to be mentally healthy?
SPEAKER_00 (18:04):
Right.
So one more question on this.
What are some strategies ormethods of coping?
So we get a diagnosis that mykid is anxious or has OCD.
What are some things that we cando at home?
SPEAKER_01 (18:21):
Okay.
SPEAKER_00 (18:23):
Are we talking about non-medicines?
Well, actually, not lastquestion.
So in addition to, I guess, thetreatment, let's go to there
SPEAKER_01 (18:33):
first.
So a lot of parents are like, Idon't want to put my kids on
medicine.
Yeah, I don't either.
But if it's extreme, that'sprobably where we'll go if we're
not, again, functioning.
First, we're going to dotherapy.
And can we do some therapy?
The best type of therapy wouldbe CBT, which is cognitive
behavioral therapy, it givesthem the techniques of what
(18:56):
happens when I am anxious.
You know, how to retrain thebrain at that point.
There's a grounding technique Imodify for kids, but it's called
3-3-3.
You have the kids to sit downand identify three different
things that they see.
Identify three different thingsthat they hear.
(19:20):
three different things that theycan feel that's going to help
them get back in the presentinstead of that anxious mind.
SPEAKER_00 (19:28):
Um, for adults, five, five, five.
SPEAKER_01 (19:29):
Yes.
SPEAKER_00 (19:30):
Okay.
For
SPEAKER_01 (19:31):
adults, it's five, five, five.
Okay.
And so you're, you know, you'regrounding yourself and, you
know, putting your feet on thefloor and then you're using more
of the five senses.
What can I hear?
What can I smell?
What can I taste?
What can I touch?
What do I see?
Okay.
And so then that kind of, okay,calm and, It's never too early
(19:52):
to teach them breathingtechniques.
Take a deep breath, hold it,take another deep breath.
That's the best thing for anykind of tantrums.
And then I also want them to geton eye level with your kid and
say, you're okay, I'm okay.
Kind of Tell me what's going on,what you're feeling, and what
(20:14):
has triggered this.
How can I help you work throughthis?
Because you don't want to be Ineed to save them because what's
going to happen when you have togo to work?
What's going to happen when theyhave to be at school?
What's going to happen atgrandma's house?
They have to learn thetechniques on how to self-soothe
and cope their self.
(20:34):
And that's exactly what thetherapist is going to do.
There's CBT for kids.
There's play therapy with theCBT.
Highly recommend it.
Here in Kentucky, we have equinetherapy.
And you can go in and do thingswith it.
the horses it's highlyrecommended yeah
SPEAKER_00 (20:53):
so okay so lots of treatment options yes and and we
don't have to just jump tomedicine we
SPEAKER_01 (20:59):
do not have to jump to medicine unless we feel like
it's some kind of very specificlike we're having anxiety
attacks and extreme phobias youknow we can't
SPEAKER_00 (21:13):
do what we need to do.
Is it something where if we haveto go to medicine, is it
something that they're on forlife or is there ways that we
can treat with medicine now andthen work on strategies to wean
off of that?
It's
SPEAKER_01 (21:26):
always your goal to get to some kind of remission.
So hopefully, no, it's not along-term medicine that you'll
have to be on for life.
But if we're talking aboutgenetics, you know, genetics is
genetics.
If everybody in your family hasanxiety, but the best thing is
if you're going to catch itearly we can give them those
coping skills or tools in theirtoolboxes i say that they can
(21:50):
use so maybe we don't need asmuch as medicine or um we can
eventually get off medicinesright
SPEAKER_00 (21:57):
yeah yeah i think that's i feel like that's
probably the goal for a lot ofparents
SPEAKER_01 (22:01):
it is it is you know it is mind altering medicines
but if we're talking about agenetic thing that's just you
know if if we were talking aboutyour heart right and you need
this medicine to live, wewouldn't be having any
questions.
But for the stigma of mentalhealth, you know, they're like,
oh, but this is exactly what Itell all my patients is your
(22:23):
brain is one of your biggestorgans.
If your brain's not functioning,how's everything else going to
function?
Right.
So if, like I said, if we'retalking about your heart, you'd
be like, give me all the pills.
If it's your brain, you stillneed that because your brain is
telling your heart what to do,what your lungs have to do and
everything else.
And so I think it's just gettingaway from that stigma of mental
(22:46):
health.
SPEAKER_00 (22:47):
And then what can we do at home?
Which I think you mentioned the333.
Yes.
And then
SPEAKER_01 (22:52):
also what we really can do at home is we need to
work on our diets and sleep.
So sleep and anxiety go hand inhand.
So that's one of the questionsthat I ask.
How well are they sleeping?
Are we having nightmares?
Are they sleeping throughout thenight?
Do they have a good bedtime?
Kids need sleep.
They do not need to be up atnight.
(23:14):
They need a routine.
So what is their routine?
They need to be, you know, youngkids needed to be in a bed by 8
8 30 they need all the sleepthey can get them teenagers they
need all the sleep they can getbecause they don't like to wake
up early in the morning but ifyou can get your sleep regulated
it's kind of like a reset andand so I do a lot of sleep
(23:36):
hygiene weighted blankets aregreat for anxiety also mood and
attention and concentration so Ihighly recommend that but food
food is my newest biggest kick Ion things.
If we don't have a clear gut,those toxins are going to cloudy
up your brain.
You're going to have more mentalhealth symptoms.
(23:57):
So if we're not eating goodfoods, if little Johnny's eating
McDonald's three times a day, weneed to get a more well-balanced
diet.
So I'm a big component onvitamins if we're not getting a
good balance, because it's hardto get kids to eat certain
things.
But we do need our fruits andvegetables.
(24:17):
All right.
Any last thoughts?
No.
I mean, just be there for yourkids.
Ask them the questions that theyneed to know.
Really, you know, take intoaccount what the teacher has to
say and know that there'sseveral different options.
It's not just all aboutmedicine.
It might be that we just need todo some modifications at home
(24:41):
and with behaviors.
And...
we're going to improve on thesekids' mental health one day at a
time.
Yeah.
And it'll make a
SPEAKER_00 (24:49):
difference for their
SPEAKER_01 (24:50):
life.
It will.
It will.
And that way, you can reallycatch it early before it...
gets worse later on in life.
SPEAKER_00 (25:00):
Well, thank you so much for joining me today.
Thank
SPEAKER_01 (25:02):
you.
SPEAKER_00 (25:03):
We'll see you all next time.
This podcast is brought to youby Frontier Nursing University
and the Woodford County Chamberof Commerce and is part of the
What's Up Woodford Network.
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