OCD in Children: What Parents Need to Know
When someone seems overly concerned about being clean, others might call them “obsessive.” When a person insists on specific behaviors or requires a certain order of things, words or actions, people may say they’re “compulsive”.
People may use the term “OCD” in an almost light-hearted manner to justify behaviors or rules which they themselves practice. But for anyone diagnosed with real Obsessive Compulsive Disorder (OCD), there is nothing light-hearted about their struggles. For them, the condition often brings distress and places limits on their every day lives to varying degrees.
According to information released by the American Psychiatric Association (APA), the best estimates are that about 1.2% of the American population struggles with OCD. It occurs in adults, teens, and children and it is likely that at least a million U.S. children wrestle with OCD symptoms (OCFMC, 2006).
Other studies predict that one child or teenager out of every 200 will develop OCD (AACAP, 2013). The average age when OCD begins is 19-1/2 years old, and 1/4 of all people who were diagnosed with OCD had developed obvious symptoms by the age of 14 (American Psychiatric Association, 2013).
Parents are overwhelmed and confused when one of their children develops the symptoms or begins to live under the dark cloud of the fears that are a part of OCD.
It’s difficult to know what to do when a child has an emotional meltdown or battles with someone who has (probably without realizing it) interfered with a “necessary” order of items and actions.
It should be good news to know that effective treatment is available. Parents should begin by learning all that they can about OCD with the goal of becoming better able to understand what a child with OCD is facing and how and where to find the right help. Newport Beach Christian Counseling can guide parents through this process, offering the support needed to find the right resources and treatment for their child’s needs.
What is Obsessive Compulsive Disorder?
OCD is a mental health issue that is diagnosed by looking for genuine obsessions and/or compulsions.
Obsession: Obsessions may be defined as urges, thoughts, or images that intrude on a person’s mind and life in a way that becomes difficult or impossible to ignore (APA, 2013). For example, someone can become a germophobe. A child may become driven to seek perfection. Another lives with the constant fear of harming themselves or others.
Compulsion: Compulsions, on the other hand, are behaviors or mental acts that a person is driven to repeat again and again. Compulsions may grow out of obsessions (APA, 2013). People with OCD find themselves compelled to continually wash their hands, perform special rituals, engage in what is known as “checking” behaviors, count things, or even pray because they believe they must.
When a person suffers from OCD, they carry out certain acts (compulsions) to try to relieve anxiety or tension (American Psychiatric Association, 2013). Often the anxiety for which the person desperately wants relief is driven by an obsession. The compulsive behavior brings a measure of relief but it’s only temporary, so when the anxiety returns, the person must perform the action again to get relief. This develops into a cycle where relief from the anxiety reinforces the need to repeat the compulsive behavior in order to experience another brief period of relief.
The obsessions and compulsions are often connected, such as germophobia and washing one’s hands. Or, a student is so afraid of failing that he or she keeps on checking and checking his or her test answers even to the point of missing recess or lunch.
In other cases, the obsessions and compulsions may not seem to be related. Think, for example, of a child who counts a certain number of cracks in a sidewalk thinking it will keep his mother from being hurt. So, a diagnosis of OCD does not always mean that the obsessions and compulsions are related. A child may have one without the other.
How OCD develops and manifests itself can also vary. Also, the focus of obsessions and compulsions shift over time. For some people, obsessions and compulsion come out more obviously and intensely when they are under stress (APA, 2013). Those same people may experience fewer or less intense symptoms in situations where stress levels are low. And often, when one obsession or compulsion is eliminated, others may change.
True OCD symptoms are not simply small irritations. They consume a major portion of the time in a child’s day. Further, they may increase a child’s level of stress, bringing layers of problems.
For example, a germophobic child may wash their hands to the point that they become dry and cracked, and may even start to bleed. Then, he or she may also become terrified of being around sick people or having physical contact with someone who has even been close to a sick person.
This can disrupt relationships, or bring on peer harassment if the fears or behaviors become known. Brothers and sisters may feel rejected by the child who struggles with germophobia because he or she may avoid giving hugs or express fear which the siblings may take personally.
OCD not only affects the person who struggles with the obsessions and compulsions, but also impacts their family and friendships. Then the OCD sufferer feels shame over their compulsive behaviors. A child’s need to carry out these compulsions often builds more shame. The emotional distress that often comes with OCD can become so heavy that depression also develops.
OCD in Children: Catching it Early
Early warnings of OCD in children may go unnoticed. Children may find certain behaviors embarrassing and may try to hide them. But parents who observe some of the following in their child’s life may have reason to seek further assistance in checking out the possibility of OCD (OCFMC, 2006; AACAP, 2013):
1. Repetitive behaviors (washing their hands over and over, touching things in a specific order, anxiously rechecking school work, or repeatedly checking doors, etc.
2. Continuous fears that become extreme (such as unusual fears surrounding germs or dirt, or anxiety about the well being of the family).
3. Often repeated statements that go beyond reasonable concern and obsessively express worry outcomes that do not necessarily follow. “I must touch [this object] 10 times so that my sister will still like me” or “When I fail to pray a certain way, our team loses.”
4. Habits and behaviors beginning to get in the way of normal life or friendships.
5. Needing reassurance too much and too often (“will I be okay if…?”; “will it be okay…?”).
6. Constantly compulsion to carry out an action until everything feels “correct.”
7. Often driven to confess bad thoughts, like sexual imagery or thinking unkind thoughts about other people.
8. Avoiding more and more activities not connected to obsessions or compulsions
9. Always seeming to be behind (because obsessions and/or compulsions demand time).
10. Increased physical symptoms of anxiety, such as headaches and stomach aches.
What Causes Obsessive Compulsive Disorder?
As is typical of much of the world of mental illness, the exact causes of OCD are still largely a mystery. In fact, a number of different factors acting in combination, including environmental and biological factors, may be behind a child’s OCD.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), states that for those individuals who have a member of their immediate family that has OCD there is a 200% greater likelihood that they will develop OCD over those whose first-degree relatives are not OCD (APA, 2013).
What’s more, they also found that when the immediate family member has experienced childhood-onset OCD, the likelihood of developing OCD increases by 1000%. Other possible causes of OCD include significant life transitions (divorce, changing schools, etc), abuse, and loss (AACAP, 2013; APA, 2013).
Whatever the cause may be in a given instance, it has become clear that OCD has a significant effect on the brain. Brain scans have shown differences in brain activity between people who have OCD and those who do not (Scharwtz, 2016).
OCD may also have physical causes, so an evaluation by a medical professional is always a good idea. Physical causes may be addressed to help reduce contributing factors. For example, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal (PANDAS) can trigger a sudden and severe onset of OCD or tic disorder symptoms (National Institute of Mental Health, 2016). In these cases, the streptococcal infection would require medical treatment.
Helping Your Child
If your child exhibits symptoms of OCD, there are a number of ways to find help and give good support.
- Get immediate professional help and counsel. There is no reason for you to try to handle this alone!
- Don’t fall into the trap of merely using reassurance as your tool to try to calm your child. This is not an effective way to reduce the symptoms nor does it teach your child to fight and manage them.
- Don’t try to avoid everything that your child fears or is obsessed by since this only tends to reinforce their symptoms.
- Give your healthy coping skills, like memorizing relevant Bible verses, relaxation techniques, evaluating the rationality of their thoughts, soothing activities, and learning to live in the moment. Stress tends to trigger and magnify symptoms, so being able to use effective stress management tools makes a real difference.
- Demonstrate how to set proper boundaries. These can help your child handle stress.
- Teach your child how to take care of themselves, like eating healthy foods and getting enough sleep,
Teach your child to recognize their obsessions and compulsions. Knowledge is a power.- Do not shame! There may be no logic behind OCD symptoms, but they are quite real and your child is not to blame.
- Provide a time and place for your child to express and process negative feelings, like embarrassment and shame, that go along with OCD symptoms.
- Find support for yourself and a place to process your own feelings about your child’s OCD symptoms. You may experience frustration and fear, along with any number of other difficult but typical emotions. Learn to take care of yourself so that you can take care of your child.
Treatment for OCD in Children
To confirm a diagnosis of OCD in children, parents should seek an evaluation by an experienced mental health professional. The DSM-5 states that OCD left untreated unlikely to go away and the symptoms will fluctuate as time goes on (APA, 2013).
Several different therapies exist for treating OCD in children. Cognitive behavioral therapy (CBT) is one of the most recommended. One kind of CBT applied quite often is known as Exposure and Response Prevention (ERP).
Much like it sounds, ERP is a type of therapy where a patient is taught not to act on any compulsion in order to ease their anxiety. Counselors will then teach a child various tools to deal with the difficult emotions.
Though the idea of asking a child not to use his or her compulsive behaviors in the face of anxiety may sound frightening, therapy can be paced so that anxiety does not become unmanageable.
Other methods of CBT, include “imagined exposure” and learning to overcome negative and illogical thinking patterns. For some children, play therapy may be a part of treatment.
Along with counseling medical, evaluation is crucial. A medical professional can help determine whether medication might help.
It may also be necessary to ask your child’s school for any help or support they may be equipped to offer. You should talk to your counselor about this.
Remember, you need not try to parent your OCD child alone! Reach out to a counselor at Newport Beach Christian Counseling today to ask questions and discuss the many options available for support and treatment.
There is hope and healing!
“Jenga,” courtesy of Michel Parzuchowski, unsplash.com, CC0 License; “Brain”, Courtesy of GDJ, Pixabay.com; CC0 License; “Tablet Time”, Courtesy of Annie Spratt, Unsplash.com, CC0 License; “Knowledge is Power”, Courtesy of Geralt, Pixabay.com, CC0 License;
By reading this article you’re taking the first step in what can be a journey of healing and hope. We’ll discuss different types of family counselors, how to select one who’s right for you, and how to budget for counseling. Take the time to consider each point in the selection process, and you’ll be equipped to make an informed decision.
Behavior intervention applies to children who are struggling with problem behaviors, or to adults who are behaving inappropriately either in public or at home. In the family therapy setting, parents and the child will work with the counselor to identify unacceptable behaviors, set boundaries, and create rewards systems, along with other helpful skills.
Children going through puberty or experiencing life stress or mental health issues may struggle to have a good relationship with their parents. They may exhibit disrespect and dislike. Parents also deal with life stressors, mental health issues, and other factors that can make positive parenting difficult.
First, consider the value you place on therapy and the perspective that it can preventative medicine for your family relationships. Yes, therapy is expensive, but as counselors, we truly believe it’s worth it.
Their arguments weren’t healthy. They would begin small and escalate to nasty fights filled with loud outbursts. It usually ended with Sarah shouting, while Zach left. Sarah felt dismissed and ignored by Zach, which irritated her, while Zach felt disrespected and was upset because Sarah would stew on things and then explode.
Psychology Today says “Emotional intelligence is the ability to identify and manage your own emotions and the emotions of others. It is generally said to include three skills: emotional awareness; the ability to harness emotions and apply them to tasks like thinking and problem solving; and the ability to manage emotions, which includes regulating your own emotions and cheering up or calming down other people.” (https://www.psychologytoday.com/us/basics/emotional-intelligence)
People who are habitually aggressive tend to fundamentally misunderstand what it means to be assertive. Specifically, they tend to confuse assertiveness with aggression and think they already are acting assertively. This is frequently a mistaken impression, however.
Refusing to accept or recognize personal behavior in a conflict is an obvious sign that the anger is not being dealt with well. Abusive behavior includes disgust directed at an individual rather than a problem, yelling, disrespectful speech, and physical contact, like hitting or kicking.
OCD can manifest itself in a number of ways and tends to manifest specific to the emotional and/or neurological structure of the individual who is suffering from it. It is characterized by a feeling of being stuck within repeating cycles of behavior and/or thinking.
K. is a female who 32 years-old is. She was promoted in her job six months back but suffers from a touch of OCD, mainly the action of touching a light switch three times prior to turning it on. No other OCD actions were significant, however. Within the past few weeks, though, she has caught herself continually vacuuming her floor to the point where she is consumed with doing so any time she is at her house. Her therapist has recommended that she not vacuum after seven in the evening and suggested that her vacuuming should not go on longer than thirty minutes each day. She is to tie a ribbon on the doorknob of the closet that the vacuum is in to remind herself of the suggestion.
When we are dealing with our typical ways of thinking, awareness and identification are about half of the battle. Our system defenses are automatic so they don’t necessarily need to be in the forefront of our thoughts in order to be used, which ultimately means that if we want to make changes in our modus operandi, we must make a purposed, conscious effort.
It also causes problems. It becomes exhausting and your thoughts can be way off track. Having your defenses up can interfere with relationships with friends and family and even with intimacy. When your defenses are always up, it is difficult to have meaningful relationships.
We hear a lot about children with ADHD (Attention Deficit Hyperactivity Disorder), but what happens when these children grow up? Unfortunately, over half of children with ADHD carry their symptoms into adulthood. They now have to face the challenges and responsibilities of adult life while dealing with restlessness, difficulty concentrating, and a tendency to be disorganized.
Adults with ADHD also have emotional and psychological symptoms such as anxiety, depression, anger, impulsiveness, low self-esteem, mood swings, and an inability to deal with frustration. As you might imagine, this can lead to conflicts with colleagues and superiors.
Most individuals with ADHD have impairment in executive function. Executive functioning takes place in the prefrontal cortex of the brain, and gives the ability to analyze, plan, and organize tasks. If a person has an impairment in executive functioning, they will have trouble self-monitoring and staying on task.
A counselor can coach you toward better job performance. Together, you can set up a schedule for your days, weeks, and months so that you’re able to be productive in the task at hand without worrying about something going undone. A counselor can help you with structuring your days and your work area and in using coping skills.
These types of emotional responses are usually short-lived and emotional balance restored within a few days. For women with depression, however, low mood is not limited to life stresses and does not simply go away once the immediate stressor has been resolved.
The fact that most people consider the birth of a baby to be a cause of celebration only exacerbates the difficulties for women with postpartum depression. Symptoms usually develop in the first few months after giving birth, but in some cases, symptoms may emerge during pregnancy.
Such factors mean that women have a greater likelihood of ruminating on negative and unhealthy thoughts, which creates a vicious cycle that prolongs depressive episodes and results in a greater severity in symptoms.
Men
In addition, children may be able to exert more control over their behavior in some kinds of circumstances rather than in others, particularly when emotions are running high. While parents find this understandably exasperating, it is normal.
There may be various explanations for why a child steals. It may be that the act of stealing is exhilarating to a child, or perhaps because it enables them to somehow feel in control. It is important to question a child’s motivation to get to the bottom of the behavior.
The child may have an active imagination and find it hard to stay present, getting lost in their imaginings. If ADHD is the cause of the problem of ignoring others, it is possible for children to be taught ways of managing their difficulties with concentration.
It is important to uncover the underlying reasons why a child feels the need to use substances – for example, is it as a means of coping? Or is it because of peer pressure from friends?
A codependent is someone who seeks out, consciously or even subconsciously, one-sided relationships that are oftentimes emotionally damaging and possibly even abusive. In this kind of relationship, the codependent usually tries to keep the other person happy by sacrificing personal time, wants, or needs. This “other person” is usually the spouse, but it may also be a parent, sibling, child, colleague, or a close friend.
Other unhealthy traits of a codependent include low self-esteem, constant fear of abandonment, and an uncertainty of who they really are. In fact, if a person has been a codependent for quite some time, they may have addictive behaviors or may be suffering from symptoms of major depression.
It is also possible that the codependent is afraid that the “other” will leave them, so they try to be a “good” wife, husband, or child. At work, there may be that fear of rejection by peers or their superiors, which causes the codependent to work extra hard, even if it is no longer healthy.
As in all problems, the initial step is to acknowledge that there is a problem with codependency. Next, one must seek for help, since overcoming it on your own will be very difficult indeed.
Emotional affairs aren’t often talked about but can be as disastrous to relationships as physical affairs would be. You might be asking yourself, “Are emotional affairs even real?”
Although you notice desires begin to arise, you tell yourself that you respect your marriage too much to jeopardize anything. As the months pass, you begin to celebrate special moments in your life with your friend at work exclusively.
Now, that you have identified what’s happening as an emotional affair. The next step is to have a conversation with someone, admitting to the emotional affair.
You might be dealing with a past hurt that you carried with you into marriage. Individual counseling can help make you healthy and whole which will then contribute to a healthy marriage.
Depression is also very common. Millions of Americans will suffer from it this year alone. Despite its prevalence, one person’s experience of depression may be very different to another’s. It is a complex illness with many varied factors and an array of different symptoms.
Thіѕ type of depression is sometimes known as “Thе Bаbу Bluеѕ.” It is common for women to experience some level of depressive feeling as their hоrmоnе lеvеlѕ change, they find themselves short on ѕlеер, аnd thеy are overwhelmed by the responsibility of parenting a child.
Thеrе are some who find themselves falling into depression durіng fаll or wіntеr. Of course, many people feel a bit low when the evenings get darker and the days get colder, but SAD is more serious than that and may result in extreme feelings of hopelessness.
Dерrеѕѕіоn саn make іt tough to take care of yourself in the most basic of ways. But actively taking part іn уоur trеаtmеnt and working with a professional to help уоurѕеlf cope wіth things саn mаkе a huge difference tо your overall state of mind.