Understanding OCD in Kids and Teens: A Conversation with Dr. Justin Mohatt

"OCD is really good at finding the weak link."

In this episode, Kaila and Dr. Sir talk with Harvard-trained child psychiatrist Dr. Justin Mohatt, a national voice on psychopharmacology in children and behavioral health design architecture for children's hospitals.

We open on the broader crisis of youth social disconnection before diving in. We explore how OCD differs from OCPD and casual "I'm so OCD" talk. Dr. Mohatt explains how symptoms shift between kids and adults and why family accommodation can quietly escalate a two-hour bedtime ritual into a household crisis. Dr. Mohatt walks through why reassurance backfires, what gold-standard treatment (ERP plus medication) actually looks like for OCD, why OCD often needs higher SSRI doses than depression, and when to consider augmenting with an atypical antipsychotic for challenging OCD cases. We close on comorbidity, suicide risk, and why careful, specialized assessment matters so much.

Dr. Mohatt's website: https://www.empirebehavioralhealth.com/justinmohatt

0:00 Cold open: how parental accommodation fuels OCD
1:51 Welcome back + introducing Dr. Justin Mohatt
2:55 Icebreaker: the youth social disconnection crisis
9:14 Bridging into OCD: why this is "a therapy generation"
10:57 Dr. Mohatt's path from sports medicine to child psychiatry
16:04 What pulled him into specializing in OCD
22:34 OCD myths: OCD vs. OCPD, and "I'm so OCD"
25:23 How OCD presents differently in kids vs. adults
33:07 Family systems, accommodation, and how OCD finds the "weak link"
39:12 Why reassurance backfires — and what to do instead
47:29 The gold-standard treatment landscape: therapy and medication
51:08 Medication dosing: why OCD needs higher doses and more time
57:52 Building a true multidisciplinary care team
1:00:24 When to add atypical antipsychotics
1:05:44 OCD, depression, and the real suicide risk
1:10:22 Closing thoughts and where to find Dr. Mohatt

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The contents of this show are for informational and educational purposes only and are not intended to replace professional medical or clinical advice. This content does not establish a patient-provider relationship. Always seek the guidance of a qualified healthcare provider for any questions regarding your health or treatment. If you are experiencing a psychiatric emergency, please call emergency services or go to your nearest hospital immediately.