When mental illness pushes kids out of control, Doernbecher psychiatrists help restore peace

Kate and Kira Smith

Twin sisters Kate and Kira Smith often talk in an excited duet, finishing each other’s sentences to share an idea or observation. Playful and affectionate, they readily hug and say, “I love you.” They are best friends.

Four years ago the twins were fighting constantly, sometimes cruelly, destroying each other’s treasured possessions. Competition and comparison ruled their relationship. Each felt an uncontrollable compulsion to do exactly what the other was doing. One would not sit down until her twin did. They worried obsessively about who was consuming fewer calories or exercising more. They were dangerously thin.

Kate and Kira felt out of control. “You can’t think about anything else,” said Kate. “You realize it’s totally irrational, but still, you can’t stop thinking about it.”

The twins’ parents, Rebecca and Preston, were desperate to find help for their daughters. But some of the mental health practitioners they spoke with didn’t seem to understand the complexity of twin relationships. Others were quick to offer a diagnosis of “eating disorder,” rather than looking deeper into the root causes of the twins’ behavior.

Life changed when Rebecca was referred to Ajit Jetmalani, M.D. at OHSU Doernbecher Children’s Hospital. Jetmalani leads Doernbecher’s Division of Child and Adolescent Psychiatry. He and his team of mental health specialists recognize that mental and physical health are inextricably linked.

With respect and compassion for each individual, Jetmalani builds patient relationships based upon honesty and trust. For Kate and Kira, these were the keys to finding their way back to a healthy relationship. “Everyone deserves a good doctor like that,” said Kira.

Jetmalani recognized Kate and Kira’s intelligence and intellectual curiosity and treated them accordingly. He diagnosed the twins with an obsessive-compulsive disorder (OCD), explained to them how it affects the brain, and shared his experiences treating other teens with OCD. He patiently but firmly challenged the girls to take small steps toward new behavior, starting with the simple act of sitting down at different times when they arrived at their weekly appointment.

Most importantly, he taught Kate and Kira that OCD was their enemy, not each other. The concept of a battle they had to win resonated with both girls, whose interests include medieval weaponry and female warrior heroines (Kate), and the Victorian era and women’s rights (Kira).

Over time, moments of calm turned into days of calm. The constant fighting stopped. The girls felt happy for the first time in years. Today, Kira and Kate say that they – not OCD – are in control.

The girls had the opportunity to express their gratitude – and their creativity – as participants in this year’s Doernbecher Freestyle program, a collaboration with Nike in which Doernbecher patients design Nike shoes to benefit the hospital. Kate’s shoe is decorated with a coat of arms and the words, “You are stronger than you think you are.” Kira’s features a playing card motif, a reference to Alice in Wonderland and its themes of madness and a key that unlocks a small door.

Parents Rebecca and Preston are deeply thankful for OHSU’s program. “My children were on the side of a cliff, stranded on a little ledge,” said Rebecca. “Dr. Jetmalani picked them up and put them on firm ground.”

Jan O’Dell
OHSU Doernbecher Children’s Hospital Foundation