Helping Kids with OCD Take Charge

Nadine has always encouraged her daughter Mary to wash her hands regularly.  Hand washing promotes healthy living as we all know! But Mary tends to wash her hands too much. Although she wants to stop, her hands just don't feel clean enough and she can't make herself turn off the water. Sometimes, she scrubs her hands until they are red and chaffed. If Mary touches anything that may foster germs, she feels she has to wash again.


Mary also worries a lot. In school during a quiz or test, she checks and rechecks every answer and erases anything that isn't perfectly straight or neat. Sometimes Mary erases so hard it tears the paper, but she has to do it. If she doesn’t Mary feels something terrible may happen. All the worrying, checking and erasing takes up so much time that she often leaves her work unfinished. 


She tries hard to hide her habits from the other kids  because they might think she's weird or crazy. Mary knows that the time she spends washing and worrying could be spent having fun with friends or doing her schoolwork. But, she can't seem to control her behavior…This is because Mary has obsessive-compulsive disorder (OCD).


All kids have worries and doubts at times. But kids with OCD are often unable to stop worrying no matter how hard they try. These worries frequently cause kids with OCD to behave in certain ways over and over again.


OCD is a type of anxiety disorder. Children with OCD become preoccupied with thoughts that something could be harmful, dangerous, wrong or dirty. They may also live in the constant fear that bad stuff will happen.   These bad thoughts and worries make up the “obsessive” part of the disorder.


Kids with OCD also feel strong urges to do certain things repeatedly. These are the compulsions. By doing things over and over, these children feel that the bad stuff will go away. Most kids with OCD realize that they really don't have to repeat the behaviors over and over again, but the biochemical ‘glitch” in their brain won’t let them stop. A child may develop OCD at the peak age of 10 or as early as age 2. 


Scientists don't know exactly what causes OCD.  But, experts believe OCD is related to levels of a chemical in the brain called serotonin (known as a neurotransmitter).. Evidence suggests OCD tends to run in families. So, a child who has a parent or relative with OCD may be more prone to the condition. Research shows certain infections as well as traumatic events may trigger the onset of OCD in high risk individuals.


Recognizing OCD is often difficult because kids can become skilled at hiding the behaviors. It's not uncommon for a child to engage in ritualistic behavior for months or even years, before parents know about it. Although hints of OCD may show through, the unknowing parent may at first only see a difficult, lazy or unwilling child. That’s why it’s essential for parents to learn the signs and symptoms of OCD so they can get prompt help for their child.  


Common obsessions parents can look out for include:

• Excessive concern over acquiring germs, diseases or illnesses

• Need to have possessions or surroundings arranged symmetrically 

• Fixation on a particular number or series of numbers

• Preoccupation with religious concerns such as afterlife, death or morality 

• Irrational fears


Some compulsions may include:

• Washing hands until they are red and chapped or brushing teeth until gums bleed 

• Checking to see the door is locked several times. 

• Need to pull socks to the same height on each leg or have cuffs of exactly equal width 

• Counting steps while walking or insisting on performing a task a specific number of times

• Performing a mindless task repeatedly until it “feels right” or redoing a task that has already been acceptably completed, such as erasing letters on a page until the paper rips

• Hoarding or hiding items under the bed 


But, wait. Don’t all kids act obsessively and compulsively now and then? Don’t you have that stash of old newspapers under the bed? So, how do parents know when it’s OCD? 

Parents need to pay attention to the frequency and severity of the obsessive compulsive behavior. Here are additional red flags that indicate a child may have OCD. They include:


• Depression  

• Sleep deprivation

• Agitation 

• Manic need to keep busy 

• Academic difficulties


If a child shows any of these signs in conjunction with obsessive and/or compulsive behavior, parents need to take action. When childhood OCD is left untreated, it can make the teenage years very difficult from a social perspective. What’s more, OCD gets harder to treat as time goes on. 


Parents can consult their child’s pediatrician. The pediatrician will evaluate your child and make a referral to a specialist that can help. 


The most successful treatments for kids with OCD are behavioral therapy and medication. Behavioral therapy, also known as cognitive-behavioral psychotherapy helps kids learn to change thoughts and feelings by first changing behavior. It involves gradually exposing kids to their fears and helping them understand that they don’t need to perform rituals to relieve anxiety and nothing bad will happen.


Once a child is in treatment, it's important for parents to learn more about OCD, modify expectations and be supportive. Kids with OCD get better at different rates, so parents should try to avoid any day-to-day comparisons and praise any small improvements. 


Don’t let OCD rule your family’s life. Health care providers, parents and family members need to work together with the child. As a team, you can show that OCD who’s boss!