Does your child count the stairs as he/she climbs up and down, or hates shaking someone's hand for fear of germs? Does he/she keeps asking whether he/she is going to die? Kids have finicky habits and phobias, but there is a difference between finicky habits and downright obsessive behavior.
Compulsive behavior in children is a common childhood anxiety disorder, as common as asthma. Yet it is often ignored and the child grows up with his obsessions and fears magnified.
What is Obsessive Compulsive Disorder?
OCD is an anxiety disorder which is characterized by intrusive thoughts or 'worries' that produce fear or uneasiness in a person. The person carries out certain repetitive actions to ease that fear. The actions seem to dominate the person's life and interrupt his/hers daily routine.
Such actions can take up hours of the day and the person's attitude can become psychotic and frenzied, especially if interrupted or unable to complete the actions. These actions vary from counting the stairs, cleaning objects unnecessarily or brushing teeth repeatedly.
They are often called rituals or compulsions. OCD sufferers can also have disturbing visions or obsessions, which they cannot stop thinking about. They derive no pleasure from their actions and do not want to perform them, but are forced to.
OCD symptoms in children are particularly disturbing, as they can cause severe emotional distress and anxiety to the child. In the age group 10-15, when friend circles are formed, OCD-affected kids are scared and anxious at the out-of-control rituals, and hence fail to socialize with others.
Kids can understand that there is something wrong about the weird thoughts, they keep having but are embarrassed or scared to tell adults, due to fear of rejection. They also justify the rituals with a 'just so' attitude. Compulsive behavior in kids is usually diagnosed between 7 to 12 years of age. 1% of children in the U.S. exhibit OCD.
OCD Symptoms and Warning Signs in Children
- Dread of germs and dirt
- Obsession with waste
- Obsession with order and symmetry
- Fear of something bad happening to a loved one
- Superstitions about numbers and figures
- Violent thoughts
- Preoccupation with items
- Religious obsessions
- Repeated teeth brushing, showering, hand washing
- Writing, erasing, rewriting
- Going in and out of doorways
- Repeatedly checking if things are off, doors are locked or redoing homework
- Feeling something or someone is "dirty" and avoiding contact
- Ordering and arranging objects
- Counting and recounting
- Stashing and collecting objects
- Repetitive coughing or eye twitching
- Repeating words or phrases in the same order
- Following a ritual before bed
- Rituals to undo or prevent something from happening
If your kid is noticeably distressed or anxious about the rituals or obsessions, then OCD is the cause. A typical impulse is to mask or hide their rituals. Parents often dismiss it as a phase, and sometimes the symptoms are so masked, that they are assumed to be a part of the child's normal behavior.
- High usage of soap or tissue
- Raw, chapped hands from constant washing
- Drop in grades and test results
- Cancellations and eraser marks on test papers and homework
- Too much time spent doing homework
- Same questions asked over and over again
- A persistent fear of illness and dirt
- Fear of family members' health and life
- Dramatic increase in laundry
- Spends a lot of time getting ready for bed
- Collecting weird objects like finger clippings
OCD Diagnosis and Treatment
Consult a psychiatrist or a psychologist if your child exhibits some of the given OCD symptoms. Note down your child's rituals and actions, as well as the time taken for each.
The doctor will ask for detailed information regarding your family's medical history, and will ask your child, age appropriate questions about his/her rituals and obsessions. If diagnosed, the two best obsessive compulsive disorder treatments to consider are behavioral therapy and medication.
Cognitive behavioral psychotherapy (CBT) focuses on the obsessions and the thoughts behind them and helps children in overcoming them. Kids are encouraged to face their fears and change their reactions to them. For example, if a child fears dirt, a therapist will show him/her how dirt is nothing to fear and play games with the kid that involve getting dirty.
These are done slowly and surely, with the child setting the pace. The child is also taught how to stop ritualistic actions and fight against OCD. Medication will help suppress some symptoms but does not reach the root worry or obsession.
A combination of CBT and medication is the standard treatment plan. Handling OCD symptoms in a child requires patience and understanding. Avoid criticizing and comparisons. Educate other family members to be helpful and what not to do. With the right attitude, you can prevent this anxiety disorder from growing up with your kid.