Stigma and Mental Health

These past few weeks many celebrities have “come out” as having mental illness. To me, it’s a strange concept that having mental illness is still an embarrassing or shameful matter. We can state the obvious, yes, that getting out there and “spreading the word” or “spreading awareness” or giving money to research institutions may help decrease the stigma of mental illness. However, at the end of the day, despite all our efforts, we have not seen a major shift in the stigma of mental illnessĀ like we have with other movements. How did those movements get momentum? It does start at the grass roots, but it has to spread. It has to spread to others who do not have a vested interest in the topic. I ask that you do your part. Your part is not just caring about mental health. If you are on my blog, then I know you already do. Your part is to spread the word to others.

Some suggestions:

  1. Try the 22 day push-up challenge, which is a great way to spread mental health awareness.
  2. Tag on Facebook or twitter once per month #mentalhealthmatters
  3. Thank others when they open up about their mental health.Ā It’s hard for anyone to open up about mental health, but let’s make it easier for others to share their experience!

I am giving a talk on Saturday (10/29/16) at the Mental Health Wellness Fair for Fairfax County Public Schools 11:30-12:20pm on kids, anxiety, and “failure to launch.” Hope to see you there!

Click to access ConferenceProgram2016.pdf


Recognizing OCD in your kids

Just like many misunderstand what is an actual clinical panic attack, versus the layman’s version of an anxiety attack, there are many who misunderstand the meaning of “OCD.”

Here is what you may think OCD is (what I have heard in my practice over the years)…

  1. Being a “neat freak” (e.g., cleaning your own house all the time, cleaning others houses all the time)
  2. Having a schedule and getting upset when someone or something messes it up
  3. “OCD” is just what someone’s personality is and nothing can be done to change it
  4. The need to control how “I” and/or someone else feels
  5. Being inflexible
  6. Being rigid

(and many others).

Clinically, OCD is diagnosed (according to the DSM-V) when there are the…

  1. Presence of obsessions, compulsions or both (there are usually both, but having just obsessions can happen as well).
    1. Obsessions-recurrent thoughts, images, or impulses that cause significant anxiety
    2. Compulsions-an overt behavior or covert thought to reduce anxiety caused by the obsession
  2. Obsessions and Compulsions are very time-consuming (e.g., usually take more than 1 hour per day) and cause distress in the family, school, or job environment.
  3. Symptoms are not better explained by a medication, physical condition, or another anxiety disorder that is more prevalent.

It is important that I note, that in kids, OCD can look like:

  1. Asking a lot of questions and reassurance, and no matter how much reassurance is given it is never enough
  2. Temper tantrums that are frequent and consistent around certain places, situations, activities, and/or people
  3. Repetitive behavior that may be hidden from the parents (e.g., turning a doorknob several times, re-taking steps, re-cleaning areas, etc.)
  4. Not getting required chores or homework done in a timely fashion or not done at all (very frequently, the amount of time and effort compulsions take leaves little room for activities we already have to get done).

What’s the good news here?

  1. Behavior therapy, particularly Exposure and Response (or Ritual) Prevention is a very effective treatment for OCD, for kids and adults.
  2. PMT (Parent-management training) is also an effective behavioral management system that will help reinforce good behaviors at home and extinguish OCD-like ones.