Your child likes to dump out their M&M’s and sort them by color before eating them. Your teenager has the same breakfast, listens to the same playlist, and wears the same socks the morning before algebra tests. Should you be worried? Probably not. Kids, and adults for that matter, sometimes do some quirky things that might not seem to be truly necessary, but that don’t cause any harm.
For some kids, however, the need to have things “just right” or to engage in specific rituals can take over their lives, and the lives of their families. Two key features of Obsessive Compulsive Disorder (OCD) are obsessive thoughts and compulsive behaviors.
Obsessive thoughts are thoughts that get “stuck” and cause distress. Obsessive thoughts can be vague such as “My books need to be perfectly straight and even on the shelf; if they aren’t right, I won’t feel right,” or can involve more specific fears of something bad happening such as, “I think I might smell bad even though I already took a shower and put on clean clothes; if I smell bad and go to school, everyone will notice and it will be horrible – everyone will hate me.”
Compulsive behaviors are things the person does to try to reduce anxiety from the obsessive thoughts. They only partially work, so the person often does these things over and over to try to help themselves feel better. They might spend an hour or more straightening those books and end up late to school, or missing an outing with friends. They might shower three or more times, change clothing multiple times, and repeatedly check with a parent to get reassurance that they don’t smell bad. They might end up being late to or missing school entirely, or skipping activities with friends.
How can a parent decide whether or not to seek a professional opinion?
When not to worry
- Your child is doing something quirky, but harmless. They are happy while doing it, and it doesn’t take up much time.
- Your child is a little upset if they can’t do the thing they want to do, but they can move on. For example, your teen might voice their displeasure if you don’t have their preferred cereal for them to eat before that algebra test, but they eat, go to school and take the test.
- They are sleeping and eating normally.
- They are going to school, having fun with friends, and engaging in fun activities.
When to consider getting a professional opinion
- Your child is experiencing a high level of distress on a regular basis related to the obsessive thoughts or compulsive behaviors.
- Even when your child is able to do their rituals, they still aren’t happy.
- There is physical harm from compulsions, such as very dry skin from excessive washing.
- Thoughts or compulsions interfere with sleeping or eating.
- Symptoms make it hard for your child to go to school or engage in other activities.
If your child does have OCD, the good news is that it can be treated. Exposure and Response Prevention therapy (ERP) works well to help children manage their symptoms of OCD.
While each child’s treatment will be designed to fit their individual needs, the general steps in ERP include:
- Learning to label the OCD; young children might want to give their OCD another name such as “Sir Boss-a-lot.”
- Learning that OCD sets off “false alarms” that make them think they’re in danger, when they’re actually safe. They start to learn that “Sir Boss-a-lot doesn’t know what he’s talking about.”
- Making a list of the situations/triggers for OCD symptoms, the “stuck thoughts” (obsessions), and the things the OCD tells the child to do (compulsions), along with a rating of how hard it would be to not do the compulsion in each situation.
- Engaging in exposure exercises which involve doing something from the list that triggers the OCD, but not doing the compulsive behavior. For example, deliberately leaving a book crooked, and not fixing it. The idea is that the child will experience the distress going away without doing the compulsive behavior. In time, this helps the child’s brain to learn to ignore the OCD false alarm related to the books.
● Repeating exposure exercises, and gradually adding new exposure exercises until the OCD quiets down enough for the child to be able to do the things they need to do and want to do without OCD getting in their way.
If ERP isn’t available, or if the OCD is severe, or isn’t getting better with ERP alone, medications such as selective serotonin reuptake inhibitors (SSRIs) prescribed by a primary care physician or child psychiatrist can also help.
Proper Citation for this blog post:
Lagges, A.M. (2023, September 21st) Could This Be Obsessive Compulsive Disorder (OCD)? Retrieved from https://infoaboutkids.org/blog/could-this-be-obsessive-compulsive-disorder-ocd