Children, just like adults, worry. This is normal and healthy, except when it begins to get out of hand and take over their life. When a child cannot stop thinking about their worries, or their day becomes interrupted constantly by repetitive actions, they could be exhibiting the early signs of Obsessive Compulsive Disorder (OCD).
Obsessive Compulsive Disorder can occur in children and it is therefore important to keep an eye on your child’s habits and make sure they are not getting out of control.
OCD can cause a child do the same thing over and over, when this occurs it is known as a compulsion or ritual.
Usually the child has no idea that what they are doing makes no sense but if they try and stop the ritual then they have feelings of extreme anxiety.
In some cases, the child feels that if they do not perform the rituals then something terrible might happen to them or someone they know. This makes them feel like it is very important to continue following through with the ritual.
It might look like the child is just being superstitious but, in fact, this type of ritualistic behavior takes a heavy toll psychologically. Rituals can be very important because they actually can suppress a violent action, in the end.
Warning Signs of Child Obsessive Compulsive Disorder (OCD)
Remember that children are sometimes prone to ‘magical thinking’ (e.g. don’t step on the cracks or the bears will get you!) and some of the symptoms listed can be perfectly normal – especially in the child with an active imagination.
However, you know you have a problem when your child is constantly distressed by these thoughts or behaviors or when they interfere significantly with functioning.
In many cases children try to contain or mask their obsessions and rituals. For this reason, parents often don’t realize for some time that their child has OCD or may think the few odd behaviors they do see are just a passing phase. As OCD usually comes on gradually, these behaviors may come on so slowly, that they seem normal to the parent.
A child may ask the parent to participate in some of the rituals at first, seeking reassurance that everything is OK. “I touched dirt, am I ok?” to which the parent responds “You’re fine.”
Failure to respond in this routine way may result in tantrums, or acting-out behavior. Very young children may ask parents to repeat a word or phrase ‘till it sounds right’.
Here are some warning signs to look out for in your child:
- Sore, dry hands from constant hand-washing
- Going through more soap than usual
- Constant concerns about germs
- A noticeable increase in laundry
- Avoidance of activities that involve getting dirty
- A sudden drop in test grades
- Handing in assignments late or not at all
- Often being late for school
- Odd requests for people to repeat words or phrases
- An extremely long amount of time spent getting ready for bed or school
- Extreme tiredness, as they stay up late at night obsessing and performing necessary bed-time rituals
- A constant worry about the well-being of family members
Symptoms of Child Obsessive Compulsive Disorder (OCD)
The symptoms of OCD in children vary and are often personal and unique to the child with the disorder. Some common obsessions and compulsions that you might recognize in your child are:
Common obsessions include:
- Fear of dirt or germs
- Need for symmetry and order
- Fixation with body waste
- Lucky and unlucky numbers
- Aggressive or sexual thoughts that are seen as “bad” or “immoral”
- Fear that something terrible will happen to a loved one
Common compulsions include:
- Washing hands over and over again
- Repetitive and lengthy teeth-brushing or showering
- Repetitive checking of doors and switches
- Collecting and hoarding specific items
- Counting items over and over
- Repeating specific words and phrases in a particular order
- Rearranging things to create order and ‘balance’
- Repeating actions a certain amount of times
- Having a strict ritual before going to bed that has to be followed exactlY
- Rituals to ‘undo’ a thought or to prevent an unwanted event
While obsessions are always present in OCD, compulsions are not necessarily a part of the disorder. While they are common, compulsions do not occur in every case of OCD. Some children experience only the intrusive, repetitive thoughts and worries (obsessions), without accompanying compulsions.
Diagnosing OCD is not something that is generally done by the family doctor. You will need to take your child to a licensed psychologist or psychiatrist. The doctor will want details on how your child is acting so it is wise to keep a journal for several weeks leading up to the appointment. Write down any ritualistic behaviors or interruptions in your child’s daily life. Make sure that you record the duration of any events that you witness.
Possible causes of OCD in children
- Genetics – studies suggest that a tendency towards anxiety may be hereditary.
- Brain chemistry abnormalities – Brain imaging studies have shown that people with OCD sometimes show different neuro-chemical brain activities than those without OCD.
- Some children feel that thinking something bad is morally just as bad as doing it. “If I think of hitting you, it’s morally the same as actually hitting you and so I must be a terrible and violent person.”
- Some children feel overly responsible for what happens around them and think certain thoughts are dangerous. “If I think that, it might actually happen and then I will be to blame.”
After diagnosis, you are likely to see your child prescribed some sort of medication but this is not the only treatment option available. Research shows that combining several treatment options into one plan tends to work really well in these cases.
If you get started on a treatment plan in the early phases of the illness then you will have a much higher chance of success and your child will likely go on to live a happy childhood. Make sure that you discuss anything that comes to mind with your child’s doctor so that you can come to a conclusion as soon as possible.
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