Introduction to Childhood OCD

A common myth is that if an individual is very tidy, and organized, doesn't like others messing up their space, and is strict about cleanliness, then they have OCD. OCD as a disorder has more to do with the disruption of one's time than cleanliness. In obsessive-compulsive disorder, as the name suggests, an individual tends to do a task or ritual, over and over again to reduce anxiety generated by disturbing obsessive thoughts.

Maintaining cleanliness or order is one of the ways individuals deal with their obsessive thoughts. 

What is Obsessive Compulsive Disorder?

OCD is a disorder of obsession with thought and compulsion of an action. But it is more intricate than that. Obsession here refers to repetitive, uncontrollable, and intrusive thoughts, or images, regarding an event, action, or object.

Compulsion refers to an action that a person will undertake to reduce the anxiety, apprehension, or fear created by obsessive thought.

These activities are harmful or have a very temporary effect. It takes up a lot of time in the day for that person to perform these activities and causes problems in day-to-day living.

Common Obsessive Thoughts are

• An extreme preoccupation with dirt or germs.
• Repeated doubts, eg: did I turn the switch off? 
• Occupied with maintaining symmetry or order.
• Paying attention to detail, multiple times a day.
• Worrying about bad luck or an unfavorable future.
• Interrupting thoughts about harm, violence, sexual activity, etc.

Common Activities Done as Compulsion are

• Counting items, or doing certain actions a fixed number of times
• Excessive washing or bathing or cleaning
• Accumulating items (with no clear future need) in huge amounts
• Doing a certain action at the same time every day. Eg knocking on the door 5 times before entering a room
• Doing a certain action following/preceding an event every day. Eg: clapping 3 times if you see a black car going on the road in front of you.

OCD in Children

While there is not a lot of difference between OCD symptoms in adults and children, there is a difference in the dysfunction it creates. Identifying OCD in kids is difficult because it can get confused with other disorders like lack of response to lower IQ or inattention to ADHD. Children also find it difficult to express what they are going through, their compulsions may not have a clear obsessive thought behind them. 

Anxiety disorder is highly comorbid with OCD in children. On average OCD stays hidden in children for a good amount of time before symptoms start causing dysfunction in daily life.

It can be seen as 

• Trying to achieve perfection in every work
• Getting a toy, or object of play before everyone else
• Being rigid in their ways. Disliking change made by others
• Picking skin, and nails, playing with hair or pacing
• Not good at sharing their things, to avoid them getting dirty or broken
• Eating food in a certain order, even plating them so that items don't mix
• Dressing in a certain order, if not properly, they will start again
• Verify information multiple times
• The child may be defiant, but not spiteful
• Once they get things done their way, they are happy 
• They do not lack social communication, they just like things their way

How to Help Your Child with OCD?

Oftentimes, unknowingly parents/family indulge in the child's rituals, mistaking them for play activities or personality quirks. They would support excessive washing, thinking it is the child trying to be neat, or letting the child have a certain ritual before going to school, believing it is the child being naughty. So the family's small contribution makes it harder for a child to understand that compulsions do not help resolve distress.

As a family, your support is essential for the progress of the child. Adhering to therapy appointments and medications is a good way to support your child. Along with maintaining a stress-free home environment, and encouraging your child.

Treatment for OCD

OCD is highly dependent on an individual thought pattern. So while an external force may be helpful, it naturally depends on the individual to change the thought pattern.

• Psychotherapy: Consulting a professional is helpful, for gaining insight into your problem, learning better-coping skills, ways to reduce anxiety, and challenging obsessive thought. 
• Pharmacotherapy: Psychiatrists also play a role to help manage intense anxiety and daily disruption with the use of medicines. 
• Family therapy:  Parents play a vital role, they need to be educated about the disorder and shown ways to help manage the child's symptoms. therapy also helps them manage stress and apprehensions about their child's future.
• School management: it is difficult to unlearn some habits, it takes time. So proper adjustments made in school will help reduce pressure on the child. 

At Udgam, we ensure that every individual gets a personalized program that targets their obsessions and compulsions while enhancing their personal strengths and reducing disruption in daily lives. Book your appointments today. Stay tuned for more information.

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Anuja Sathe

Counselling Psychologist