Most people have heard of OCD (obsessive-compulsive disorder). It is the condition Jack Nicholson’s character has in the movie “As Good as it Gets.” It’s been featured on television programs such as 60 Minutes, Dateline and Oprah. OCD is, in fact, much more common than was previously thought, directly affecting at least one person in 40 in the general population.
What is really shocking, however, is how many children suffer from OCD. According to Tamar Chansky, the author of Freeing Your Child from Obsessive-Compulsive Disorder and the director of the Children’s Center for OCD and Anxiety in Philadelphia, there are more than a million children in the United States today with OCD. Chansky also reports that the condition affects at least one in 100 American children and that the average age of onset is 10.2.
Adults with OCD usually know they have a problem. They are able to separate their obsessive-compulsive thoughts and behaviors from normal, healthy thoughts and behaviors, which is considered the first step on the road to recovery. Children, however, generally do not have enough life experience or self-awareness to make this critical distinction. When they find themselves performing bizarre or repetitive rituals, such as washing their hands over and over, they are ashamed and feel like they are going crazy.
Often, these kids are too embarrassed to tell their parents or an adult what is going on. This is why it is so important that adults are aware of OCD and knowledgeable enough about it to detect it in children. As a parent, you will need to guide your child through the acceptance and recovery processes step-by-step.
OCD: Recognizing the Problem
What is OCD exactly? Chansky suggests we think of it as a “brain glitch,” in which the brain sends false messages — such as “the stove is still on,” or “there are harmful germs on the telephone” — and the affected person needs to perform rituals to shut off the voice delivering the message. Because OCD is a vicious cycle, though, the voice doesn’t get shut off — it becomes louder and more insistent instead.
The good news is that OCD, in adults as well as children, is highly treatable. Most people with OCD are able to retrain their brains to ignore the false messages until they just stop getting sent. But how do you know if your child has OCD? Kids often become experts at hiding their symptoms because they feel humiliated and scared.
What parents can do is make their children feel safe and comfortable and watch them carefully for any of the following signs:
- Contamination — excessive concern over germs, disease, illness, contagion.
- Harm to self or others — irrational fears such as causing a car crash, stabbing him- or herself or another person with a knife or other sharp object, etc.
- Symmetry — need to have possessions or surroundings arranged symmetrically or to move in symmetrical ways.
- Doubting — becoming convinced that he or she hasn’t done something he or she is supposed to do.
- Numbers — fixation on a particular number or series of numbers; performing tasks a certain number of times regardless of sense or convenience.
- Religiosity — preoccupation with religious concerns such as the afterlife, death or morality.
- Hoarding — stockpiling of useless or meaningless objects such as old newspapers or food.
- Sexual themes — obsessive thinking about sex; disturbing writing or doodling of a sexual nature.
- Washing and cleaning — washing hands until they are red and chapped; brushing teeth until gums bleed.
- Checking — returning to check that the door is locked more than once.
- Symmetry — need to have socks at same height on each leg; cuffs of exactly equal width.
- Counting — counting of steps while walking; insistence on performing a task a specific number of times.
- Repeating/redoing — performing a mindless task repeatedly until it “feels right;” redoing a task that has already been acceptably completed, such as erasing letters on a page until the paper wears through.
- Hoarding — hiding food under the bed; refusing to throw away soda cans or gum wrappers, for instance.
- Praying — excessive, time-consuming repetition of protective prayers or chants.
Of course, many of us, at some point in time or consistently, engage in one or even a few of the above obsessions or compulsions. For example, on a stressful morning, it is not abnormal to check that you’ve locked the front door twice. You may hold onto old newspapers or magazines for what others consider an excessive period of time. But if you notice your child engaged in several of these activities over a period of weeks, observe him or her very carefully for signs of the following, which may indicate the presence of real obsessive-compulsive behavior and possibly full-blown OCD:
- sleep deprivation
- depression or shame
- slowness in performing everyday tasks such as getting dressed in the morning or preparing for bed
- manic need to keep busy
- academic difficulties, including slowness to complete easy work
- behavioral difficulties such as angry outbursts when questioned about odd rituals or desires (such as his or her need for symmetry)
- social difficulties or a desire to spend excessive time alone
- family conflict over usually mundane details, such as the way the table is set
Obviously, many kids have superstitions (avoiding sidewalk cracks, wearing a lucky T-shirt), obsessions (baseball cards, musical groups) and compulsions (hair flipping, nail biting), and many of the above manifestations affect non-OCD children for an infinite number of reasons. What you are looking for is signs of the obsessions and compulsions and several of the manifestations in a child who appears to have a lot on his or her mind.
Talk to your child if you think you may be on to something — he or she may well be relieved you have noticed and could be eager to tell you what’s going on. If not, you will still glean information based on his or her reaction. Then it’s time to get help.
For a referral, contact the OC Foundation at (203) 315-2190 or at www.ocfoundation.org. According to Chansky, what you want is a behavior therapist who is also an expert in childhood OCD. Although you may eventually want to talk to a psychiatrist about SSRIs, your therapist can help you make that decision; medication is not always necessary to treat OCD in kids.
Remember That No One’s at Fault
You must know and believe that your child is not trying to aggravate you with obsessive-compulsive behavior, no matter how annoying it may be. He or she can’t help it — OCD is a biochemical brain glitch, not a psychological condition, and the behaviors most likely annoy your child even more than they annoy you.
OCD has nothing to do with your parenting skills, your neurosis, or anyone’s neurosis, any more than the chickenpox or the flu. And although this is especially difficult for parents, whose instincts tell them to do all they can to ease their child’s pain, understand that you are not helping your child by participating in his or her obsessive-compulsive rituals. The best thing you can do is help your child learn to stop.