Identifying Obsessive Compulsive Disorder in Children

Obsessive Compulsive Disorder (OCD) is an anxiety disorder that causes someone to have intruding and recurrent thoughts, called obsessions. These intruding thoughts can become all-consuming. Compulsions are strong urges to do something over and over to feel a sense of relief from these obsessions. They’re often referred to as rituals for this reason. Compulsions are a clever way to feel better at first because they immediately reduce anxiety. Unfortunately, they can increase over time and become all-consuming as well, making the person to feel even worse.

Obsessions and compulsions work together, like a game of volleyball. You need both to keep them going. Compulsions feed obsessions. By working to resist urges to do compulsions, someone with OCD can diminish their obsessions.

According to the International OCD Foundation (1), common obsessions and compulsions include:

Obsessions

• Worrying about germs, getting sick, or dying.
• Extreme fears about bad things happening or doing something wrong.
• Feeling that things have to be “just right.”
• Disturbing and unwanted thoughts or images about hurting others.
• Disturbing and unwanted thoughts or images of a sexual nature.

Compulsions

• Excessive checking (re-checking that the door is locked, that the oven is off).
• Excessive washing and/or cleaning.
• Repeating actions until they are “just right” or starting things over again.
• Ordering or arranging things.
• Mental compulsions (excessive praying, mental reviewing).
• Frequent confessing or apologizing.
• Saying lucky words or numbers.
• Excessive reassurance seeking (e.g., always asking, “Are you sure I’m going to be okay?”).

The truth is, most people repeat certain behaviors from time to time and it’s common for children to have rituals or routines before school, after school or at bedtime. OCD rituals differ in that they become too frequent, and most importantly, they’re upsetting to the child and get in the way of everyday activities.

Some people wonder if OCD is the same as worrying, but it’s not. Worries come and go, such as, “What if I’m not good enough to make the team?” or “What if I don’t have anyone to sit with at lunch?” With OCD, the same upsetting thought comes back again and again.

Children don’t always know how to talk about their obsessions and compulsions. It doesn’t make sense to them so how could it make sense to someone else? They may wonder what’s wrong with them or why they’re like this when no one else seems to be. It can be embarrassing. For this reason, they can be very good at hiding their symptoms and suffering in silence.

Parents may notice the following behaviors in children with OCD:

• You are always waiting for them. Timely transitions are difficult for children with OCD because they’re functioning within the time constraints of their OCD. Compulsive behaviors may take time to get “just right.”
• They take a long time to do everyday tasks, such as taking a shower, washing their hands, getting dressed, finishing a project.
• They may repeat the same actions in the same order repeatedly, such as turning in place, touching the same spot, counting to a certain number, washing their hands.
• They have trouble relaxing and enjoying themselves. Children with OCD may feel irritable, and anxious a lot because they’re constantly focused on relieving their anxieties through their compulsions.
• They may get very upset if they can’t make something just right or if something is out of place.
• They may insist that others say or do something an exact way.
• They may have trouble making up their minds.
• They may ask for reassurances from you often.

It’s very important for parents to seek help if they sense their child may have OCD.  OCD is diagnosed by psychologists or psychiatrists through interview with parent and child. There are no medical tests which diagnosis it. If you have a child suffering with this disorder, there is help. Treatments involve Cognitive-Behavioral Therapy and possibly medication.