Have you ever noticed your child having recurrent & intense obsessions or compulsions that cause him/her severe discomfort and interfere with day to day activities or functions? Have these obsessions become recurrent and persistent thoughts or impulses that are unwanted and cause your child to have marked anxiety or distress? Are these obsessions becoming more unrealistic or irrational? Are his/her compulsions repetitive behaviors or rituals like hand washing, keeping things in order, checking something over and over or are they mental type of activities like counting or repeating words silently? Are these obsessions or compulsions causing your child significant distress or anxiety to the point that they are interfering with normal routine tasks, academic functioning, social activities or relationships? If you said yes to most of the above, your child may be suffering from Obsessive-Compulsive Disorder.
What is Obsessive Compulsive Disorder in Children?
According to Stanford Children’s Health (http://www.stanfordchildrens.org/en/topic/default?id=obsessive-compulsive-disorder-in-children-90-P01628), “Obsessive-compulsive disorder is an anxiety disorder in which a person has an unreasonable thought, fear, or worry that he or she tries to manage by performing a ritual activity to reduce the anxiety. Frequently occurring disturbing thoughts or images are called obsessions, and the repeated rituals performed to try to prevent or dispel them are called compulsions.”
You lose entire blocks of your day
to obsessive thoughts or actions.
I spend so much time finishing songs in my car
before I can get out or redoing my entire shower routine
because I lost count of how many times I scrubbed my left arm.”
This article noted that during normal growth and development of children and adolescents, there is a purpose and focus for rituals and obsessive thoughts that are based on age. For instance in preschool children there are routines that are done around bedtime, bath time, or mealtime to assist them to stabilize what is expected of them and to give them an understanding of their world. For school-aged children they develop normal group rituals like team sports or playing games in a group. The article went on to say older children and teens begin to develop hobbies and collect things that they like. These types of rituals help the children to socialize and control their anxiety.
Stanford Children’s Health said that, “A child or adolescent with OCD has obsessive thoughts that are unwanted and related to fears (such as a fear of touching dirty objects) and uses compulsive rituals to control the fears (such as excessive hand-washing). When OCD is present, obsessive thoughts and compulsive rituals can become so frequent or intense that they interfere with activities of daily living (ADLs) and normal developmental activities."
that plays over and over in your head,
only you can’t get rid of it.”
What Are Obsessions?
According to Kids Health (http://kidshealth.org/en/parents/ocd.html) “Obsessive-compulsive disorder (OCD) is a condition that causes kids to have unwanted thoughts, feelings, and fears. These are called obsessions, and they can make kids feel anxious. To relieve the obsessions and anxiety, OCD leads kids to do behaviors called compulsions (also called rituals).”
Kids Health listed the following OCD fears:
- they, or someone else, will get sick, hurt, or die
- they said a bad word, had a bad thought, or made a mistake
- they have broken a rule, done a bad thing, or sinned
- something is clean, dirty, or germy
- something is straight, even, or placed in an exact way
- something is lucky or unlucky, bad or good, safe or harmful
What Are Compulsions?
Kids Healthstated, “Compulsions (rituals) are behaviors that kids with OCD do repeatedly. OCD causes kids to feel they have to do rituals to "make sure" things are clean, safe, in order, even, or just right. To kids with OCD, rituals seem to have the power to prevent bad things from happening.”
Like you’re being forced to do an endless number
of completely random, pointless tasks you don’t want to do.
It’s so exhausting and emotionally draining
— like your brain needs an off switch!”
Kids Health listed the following OCD rituals:
- washing and cleaning
- often erasing things, re-writing, re-doing, or re-reading
- repeating a word, phrase, or question much more than necessary
- going in and out of doorways several times in a row
- checking to make sure a light is off, a door is locked, or checking and re-checking homework
- touching or tapping a certain number of times, or a set way
- having things in a specific order
- counting to a certain 'good' number, avoiding "unlucky" numbers
What Are the Symptoms of OCD in Children?
The presence of obsessions or compulsions, or both is what distinguishes obsessive-compulsive disorder from other conditions. These obsessions or compulsions can be so stressful that it becomes time-consuming and will interfere in a person’s daily life and normal functioning. It should be noted that OCD in children and teenagers can begin very gradually and then worsen with age so symptoms of OCD can also be mild or severe.
and nobody else can see it.”
According to Healthy Place (https://www.healthyplace.com/ocd-related-disorders/ocd/ocd-in-children-signs-symptoms-causes-treatments) the following is an example of obsessive thoughts and Compulsive behaviors in OCD kid:
Obsessive thoughts in ODC children:
- Excessive preoccupation with germs, dirt, illness
- Expresses repeated doubts, such as whether the stove is turned off
- Intrusive thoughts about a parent getting hurt
- Excessive preoccupation with symmetry, order, and exactness
- Disturbing thoughts that do not align with personal religious training
- Excessive drive to know or remember facts that seem very trivial
- Unreasonable attention to detail
- Excessive worry about something bad happening like a car accident or home intruder breaking in
- Aggressive thoughts and urges (may be more likely in teens)
Compulsive Behaviors in OCD children:
- Washing hands excessively, frequently over 100 times a day
- Repeated checking and rechecking to ensure stove is turned off or door is locked
- Rigidly follows self-imposed rules of order like arranging personal items in room in a particular way and becoming very upset if someone disrupts the arrangement
- Excessive counting and recounting
- Preoccupation with sequencing or grouping objects
- Repeatedly and excessively asking the same questions
- Repeating words spoken by self or others
- Repeating sounds, words, numbers, or music to him- or herself
What Are the Causes of OCD in Children?
Many articles stated that the experts in the field don’t really understand the causes of the development of OCD in children or in adults. Research has indicated that OCD is a neurological brain disorder. There is evidence that suggests that people with OCD have a deficiency of a chemical in the brain called serotonin. Other studies have shown that OCD has a tendency to run in families which imply a genetic component. But it should also be pointed out that OCD can develop in a family without any history of OCD. One interesting recent study suggest that streptococcal infections may actually trigger the onset of OCD or increase its severity in some cases.
a rational brain and an irrational brain.
And they’re constantly fighting.”
Some Basic Facts About OCD
In an article by Anxiety BC (https://www.anxietybc.com/parenting/obsessive-compulsive-disorder)they they listed some facts about OCD as follow:
- OCD can begin early, starting between ages seven and 12. In fact, up to half of all adults with OCD say their symptoms started when they were children
- OCD is more common in boys than girls in childhood, but into adulthood, women are affected at a slightly higher rate than men
- OCD symptoms can change over time. For example, when OCD first appears your child might begin with excessive washing compulsions, but over time this can shift to excessive checking compulsions while compulsive washing disappears
- OCD occurs in 2-3% of children and adults during their lifetime
Seeking reassurance from others that things will be okay or a ritual was completed “correctly” is common in children and teens with OCD. This can include asking parents and siblings to do rituals as well
Treatment For Obsessive-Compulsive Disorder
Most articles generally stated that specific treatment for OCD will be determined by the followings variables: The child’s age, overall health and medical history, the extent of the symptoms displayed by the child, the child’s tolerance for specific medications or therapies, the expectations for the condition outcomes, and the parent’s opinion and preference.
According to Medical News Today (http://www.medicalnewstoday.com/articles/178508.php), if OCD is “left untreated, OCD usually develops into a chronic condition with episodes where symptoms seem to improve. Without treatment, remission rates are low, at around 20 percent.”
Medical News Today stated that treatment is generally cognitive behavioral therapy (CBT) or selective serotonin reuptake inhibitors (SSRI) or a combination of both.
What Is Cognitive Behavioral Therapy?
Mayo Clinic (http://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/home/ovc-20186868) describes CBT as follow, “Cognitive behavioral therapy (CBT) is a common type of talk therapy (psychotherapy). You work with a mental health counselor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.”
Thoughts go in your head, get stuck
and keep going around and around.”
According to the OCD Center of Los Angeles (https://ocdla.com/whatisocd) Cognitive-Behavioral Therapy advances have been made which has led to the development of a new therapeutic approach that is very effective in treating OCD. This new approach is called Exposure and Response Prevention (ERP) and has significantly changed the therapeutic management of OCD. According to this article by OCD Center of LA this new ERP is more proactive and less time consuming than psychoanalysis.
Medical News Today (http://www.medicalnewstoday.com/articles/178508.php) stated that research has shown that 75% of OCD individuals are helped with this intervention. Treatment techniques in ERP are as follows:
- Exposure - exposure to situations and objects that trigger fear and anxiety. Over time, the anxiety generated by these obsessional cues decreases and, eventually, the obsessional cues cause little or no anxiety. This is called habituation.
- Response - response prevention refers to the ritual behaviors that people with OCD engage in to reduce anxiety. This treatment helps patients learn to resist the compulsion to perform these rituals.
I'm a freak.
A neat freak,
or so to speak.
has its own little place.
Must be straight,
must look tight,
or i find it hard to sleep at night.
and talk about my O.C.D.
But I can see you problems big,
compared to me you are a pig.
it's so disgusting,
shut your mouth.
but I'd wear gloves to touch your doors.
So please don't stand so close to me,
I would prefer to stay germ free.
In closing preventive measures to reduce the number of OCD cases in young children are not known at this time, however, early detection and intervention is the key to reducing the severity of OCD symptoms and enhance the young child’s quality of life. Parents, teachers and other caregivers who work with young children should all be afforded all the information and education about these debilitating childhood disorders that can be treated early to ensure a better life for our children.
Thank-you for reading my article on Childhood Anxiety: Obsessive-Compulsive Disorder. I will continue with the last anxiety disorder in my next article. Thank-you for joining me in this journey about Childhood Anxiety. If you would like to follow me, please check HERE.
These are my previous articles on Childhood Anxiety if you are interested in reading it:
Childhood Anxiety: The Anxious Child
Childhood Anxiety: What Types of Disorders Do Children Have to Deal With https://steemit.com/steemiteducation/@cabbagepatch/childhood-anxiety-what-types-of-disorders-do-children-have-to-deal-with
Childhood Anxiety: Selective Mutism Disorder
Childhood Anxiety: Separation Disorder: