What is OCD?
OCD, or Obsessive Compulsive Disorder, is an anxiety related disorder that can occur in children as well as adults. People with OCD have persistent, reoccurring thoughts or obsessions, about unfounded and exaggerated fears. These obsessions of fear can be about almost anything, but will typically involve being contaminated, behaving improperly, or being violent. These fears usually lead to doing repetitive rituals or routines, called compulsions, such as repeated hand washing, counting, repeating phrases and hoarding and is an attempt to deal with the fear and anxiety.
How Common is OCD in Children?
It is estimated that about one in every 100 kids may have Obsessive Compulsive Disorder. Children are usually around 10 years of age when diagnosed, although children as young as two or three can exhibit symptoms of OCD. Boys are more likely to develop this disorder before puberty, while girls tend to develop it during adolescence. By the teen years the occurrence is about evenly split between boys and girls. OCD is often seen to run in families.
Common Obsessions with Children:
- Fear of harm or danger to loved one or self (i.e., if I count to five every time I talk to my father, he won’t die)
- A need for perfection (i.e., re-writing an assignment instead of erasing a mistake)
- Fear of losing something valuable
- A need for symmetry and order
- Intrusive words or sounds
- Aggressive/sexual thoughts
- Religious fixations
Common Compulsions with Children:
- Washing and rewashing hands to avoid exposure to germs
- Arranging or ordering objects in a very specific way
- Repeating a name, phrase or tune
- Counting or touching rituals
- Hoarding or saving useless items
- Seeking reassurance or doing things until they seem perfect
Signs of OCD
It may be difficult for parents to recognize symptoms in a child, as children will take great care to hide their behaviors. Symptoms can go on for months or years before a parent will even begin to realize there is a problem. Children and teens may be able to overcome the obsessions and compulsions at school but not at home, or vice versa. Symptoms can fluctuate and be greater during a stressful period, such as around holidays or when school starts.
Things to Look for in Children
Some of the signs that a child is obsessing or secretly performing rituals can be seen in the following observations:
- rough, red hands from constant washing
- a sudden increase in laundry
- an unusually long time spent completing homework
- holes erased through tests or homework
- a sudden drop in grades, school performance
- requests to family members to repeat phrases over and over again
- constant fears that something bad will happen to a family member or other loved one
- extreme distress or tantrums if a ritual is interrupted
- difficulty concentrating at school due to repetitive and intrusive thoughts
- social isolation or withdrawal from peers
The Affect of OCD
Obsessive Compulsive Disorder can affect nearly all aspects of a child’s life, including their success at school, personal relationships with family and peers, and even their physical health. The constant obsessions and compulsions in children may make it difficult for them to concentrate in class and complete homework, or even make friends. Odd behaviors can often result in teasing from other children. There are usually coexisting physical symptoms such as headaches, stomachaches and other stress-related ailments.
Treatment for OCD Obsessive Compulsive Disorder is usually treated with combinations of different therapy approaches and medication. Here are some of the treatment options that are available:
- Cognitive-Behavioral Therapy (CBT): The therapy focuses on developing positive thinking and behavior patterns, as opposed to the negative ones that trigger OCD symptoms, and to try alternate replacement behaviors.
- Exposure and Response (ERP) Therapy: A therapist exposes a child to an obsession and prevents him or her from performing rituals or avoidance behaviors for a certain period of time that increases with each session. Although this is very difficult and can cause anxiety in the beginning, these feelings soon begin to diminish and sometimes disappear completely.
- Medication: Medication such as a selective serotonin reuptake inhibitor (SSRI) is used in combination with therapy. It works on the anxious symptoms that often accompany exposure therapy, giving it a fair chance to work.
Co-occurring DisordersOCD can occur on its own, but is usually accompanied by one or more other co-occurring disorders. Some of these include: Tourette’s syndrome, attention- deficit/hyperactivity disorder (ADHD), depression, social anxiety, and panic disorder.