Out of the Shadows: Obsessive-Compulsive Disorder in Children

October 25, 2011

Let’s face it: we’re all a little obsessive at times. There are some things we’ve done the same way since we were children. But what happens when a child is so adamant about certain actions that it becomes clinically diagnosable?

Childhood-onset Obsessive Compulsive Disorder, or OCD, is not uncommon. But it can be difficult to diagnose. What’s the difference between a clean kid and an obsessively hygienic kid? How can you tell a young child who likes to open and shut the door apart from a child who feels like they have to shut the door three times?

The answer is usually right in front of us. This is especially true when kids, unlike adults, are unable to distinguish “strange” behaviors from normal ones.

Externally, extreme cases of OCD affect a child’s sleep pattern and social interactions. Some children will instigate seemingly pointless fights with family members over things that seem mundane, such as the symmetry of objects on a dresser, or the way food is presented. Internally, severe OCD can result in depression, feelings of shame, and mania.

While the compulsive aspect of OCD can be easier to spot, there are times when OCD manifests in a way that we can’t see. A child may have intrusive thoughts, fears, or images which routinely afflict them. Anxiety, stress and trauma tend to worsen symptoms.

According to the NYU Child Study Center, OCD is thought to be neurological in origin. It’s also often hereditary. An estimated 20% of children who are afflicted with OCD have a family member with the disorder.

Kids with OCD are usually overwhelmingly preoccupied with things that usually seem irrational. They become ritualistic in bolstering their obsession. Common examples of obsessions in children are contamination—constant concern over germs, irrational fears, symmetry of objects, religiosity, hording, and numbers.

Compulsions usually result in actions, which are a proponent of the obsessions. They manifest in many ways, such as excessive handwashing, repeatedly making sure things are a certain way (IE making sure a door is locked), or counting. Children with OCD will often become upset when the result of one of their compulsions is changed or flawed.

On the up-side, OCD in children is not only highly treatable, in some cases it fades with age. Treatments available for children with OCD include an array of medications, or talk-therapy.  Developing coping strategies and being able to recognize and understand the obsessions, sometimes has the ability to moderate symptoms.

There are many resources for parents of children with OCD. More information on OCD and treatments for OCD can be found at KidsHealth.org and ocdchicago.org.