John has a PhD in psychology and teaches college courses in human behavior. He writes about air and space, human behavior, and mysticism.
OCD and the Child
OCD in Teens and Children
Does your teen complain of persistent, intrusive thoughts that seemingly come out of nowhere? Does your son or daughter engage in bizarre, ritualistic behaviors for no particular reason?
Have you noticed that your youngster does things like repetitive finger tapping, excessive hand-washing or endless counting? Do these behaviors interfere with activities of daily living?
If you answered yes to any of these questions, your child may have OCD. Obsessive Compulsive Disorder (OCD) is an anxiety based disorder that affects millions of people each year. It is common across all age groups, including children.
Knowing the unique signs and symptoms of OCD in that may be happening with your child is important because the clinical manifestations differ from their clinical presentation in adults. As a counselor, this is a topic that comes up frequently in my Couples Therapy Chicago practice.
OCD Facts and Teens
This article will explore specific information about OCD and provide 8 concrete behaviors that you should look for in your child to assess if your youngster has OCD.
Resources for wellness and treatment options will be discussed so that you can help your child work through some of the anxiety she/he may be holding.
Additionally, an OCD video has been made available to offer greater insight. At the end, an OCD poll has been posted for you to vote in.
We have lots to cover. Are you ready? Let’s jump right in!
What is Obsessive Compulsive Disorder?
In simple terms, OCD is an anxiety disorder involving obsessions about a wide variety of issues and themes. In order to stop the obsessions, the person will engage in behaviors (compulsions) to make the intrusive thoughts go away.
OCD related obsessions in teens
OCD can involve a number of obsessive thoughts that are irrational and unwanted. Many of these thoughts take on negative attributes. In children, there are typically eight common themes (signs) that these obsessions revolve around.
Disclaimer: The OCD themes mentioned here are offered in broad strokes and do not represent the entire gambit of behaviors. Think of the material presented in general terms. Additionally, onset of OCD symptomology can occur due to a medical condition. It is important to have your child evaluated by a doctor to rule out other causes.
It is important to have your child evaluated by a doctor to rule out other causes.
1. Counting and numbers
Children with OCD often are fixated on counting and numbers. An example might be a 10-year old boy who ritualistically taps a spoon to his teeth 7 times before eating. Another example might be a 12-year old girl who is compelled to count the number of books on a shelf before pulling one out to read.
- Counting cracks on sidewalk
- Touching an object a specific number of times
- Locking a door ten times
Many youngsters with OCD will hold anxiety producing thoughts about forgetting to attend to a given task. An example might be forgetting to close the microwave door or forgetting to flush the toilette. To compensate for these doubts, the child will repeatedly “check” to make sure the task is attended to. The keywords here are self-doubt and repetition.
- Checking schoolbag repeatedly to make sure it’s zipped close
- Repeatedly making sure oven light is turned off
- Repeatedly checking to make sure house-keys are in a pocket
Kids with OCD often become fixated with making sure that a given object is “perfectly” arranged or place in a certain way. Here were are talking about a child being more than just organized and “neat”.
An example might be a 12-year old boy who must make sure his smart-phone is placed in perfect aligned with the corners of a table. He may spend hours on this task. Another example might be an 8-year old girl checking multiple times to make sure her doll is standing perfectly straight.
- Making sure clothing in drawers is perfectly folded and stacked
- Obsessions with shoes being perfectly aligned in closet
- Fixation with pencils being perfectly sharpened and laid out on desk.
Little ones with OCD may be fearful of catching germs. In these situations, the behavior will present with ritualistic behaviors designed to prevent or “ward off” sickness.
An example might be a 7-year old boy who excessively washes his hands out of fear of catching a virus. A 9-year old girl might ritualistically use anti-bacterial gel to prevent “the cooties” from infecting her.
- Unusual knowledge of various pathogens and diseases
- Hypochondriasis (aka Hypochondriac)
- Irrational fears of contracting an exotic virus or illness (i.e. Ebola).
Key Clinical Features
The essential psychological features include fear and anxiety.
— Dr. John Moore
Some kids with OCD engage in hording behaviors. The essential psychological features include fear and anxiety.
A 12-year old girl pay stockpile magazines, irrationally fearful that she may need to access one for information in the future. A 15-year old boy may stockpile cans of food; fearful the world is about to end.
- Collecting electronics that serve no purpose
- Stockpiling dolls and toys that are broken
- Saving cloths that no longer fit
Violence against others or self
6. Self-Harm/Harming Thoughts
OCD in many children cause them to fear harming themselves or someone else. Examples include a 10-year old boy who is fearful of stabbing someone with a knife.
An 11-year old girl has fears of smashing her hand or someone else with a hammer. The essential characteristic in these examples are intrusive thoughts that involve violence or harm.
- Fears of harming the family pet
- Reoccurring thoughts mommy will get hit by a truck
- Intrusive thoughts involving self-harm
Some children with OCD become fixated on issues connected to religion or spirituality. Many of the themes involve excessive thoughts about death, dying and the afterlife.
Examples include an 8-year old girl who is consumed with the spirit life.
A 13-year old boy becomes fixated with the death of a celebrity.
- Being consumed with plane crashes
- Over-attachment to spiritual figures
- Over-attachment to superstitions
- Consumed with where spirits
8. Sex based themes
There are a fair number of children who present with OCD symptoms involving sex. Usually, the thoughts are obsessive and can involve verbal remarks, writings and pictorial representations.
A 15-year old boy may be consumed with thoughts about “making it” with another person. A 10-year old girl may draw pictures involving adult behaviors.
- Hiding adult themed magazines
- Internet surfing on inappropriate sites
- Writing stories involving intimate relations
Obsessive and can involve verbal remarks, writings and pictorial representations.
— Dr. John Moore
OCD Related compulsions in teens
In order to compensate for the obsessions described above, children will engage in a variety of compensatory behaviors. The children hope that by partaking in these actions, they will be able to prevent the negative event they fear from taking place (i.e. illness, death, punishment).
“Awfulizing” is a very real fuel source behind the compulsive behaviors. The term awfulizing is a 25-cent term used to describe a situation where a person believes the most awful outcome is likely going to happen.
An example might be a 12-year old girl who has intrusive thoughts about her mother walking out the door and slipping on ice; causing mommy to crack her head open and die. With awfulizing, there is no middle ground. It is always the worst possible outcome.
What can make OCD worse?
Children with OCD often find their symptoms become amplified during high periods of stress. An example might be an airplane trip to visit grandma or the first day of school after summer break. While OCD behaviors in kids usually remain constant but can worsen during periods of high stress.
Diagnosing OCD in teens
OCD often goes undiagnosed in children. This happens as a result of parents chalking up behaviors to “kids just being kids” and misbelieving the child will “grow out it” (FYI: they won’t).
Generally speaking, doctors and therapists will consider the following three factors when making a diagnosis of OCD in children:
(1) Obsessive/Ritualistic Behaviors lasting for more than 1-hour a day
(2) The behaviors interfere with activities of daily living (i.e. late to school)
(3) The obsessions cause distress for child and family members.
At what age do we see OCD in children?
OCD typically is diagnosed in youngsters who are between the ages of 7-12 because this is when obsessions become most prominent.
This is also a time period in life when children begin to grow into who they are and their world, which can complicate making a diagnosis. The essential feature most clinicians will look for is a history of obsessive/ritualistic behaviors.
What causes OCD?
It is believed both biological and psychological forces are at play regarding OCD. Many scientists strongly feel there is an evolutionary component at play.
Children who have OCD symptoms often have family member with this disorder. This family member can be on the mother or father’s side. Twins often have OCD – both identical and fraternal.
Treatment for OCD in children
Treating OCD for teens and children
The good news for children and parents is that OCD is treatable. It is important to note that no child (or adult) is ever “cured” of OCD. Instead, children learn to work through irrational thoughts and compensate in healthier, more productive ways.
Let’s take a quick look at the different treatment options:
Cognitive Behavioral Therapy
Cognitive Behavior Therapy (CBT) uses counseling techniques that are designed to help children learn to recognize the irrational nature of their thoughts and become more aware of obsessive patterns. CBT therapists work with children to help them replace unhealthy thoughts with more rational, harmonious thinking.
This type of therapy involves exposing the youngster to their sources of fear. Commonly combined with CBT, the child is asked to sit with her/her feelings while facing the anxiety producing stimuli. An example might be a child who has alignment obsessions being gently exposed to an unorganized drawer. Another example might be a youngster afraid of germs being slowly exposed to a dirty washcloth.
Exposure therapy is only effective when the child is able to “be with” the triggering source of anxiety and not compensate through ritualistic behaviors.
This kind of therapy is considered a “here and now” therapy, used to help children and adults remain in the moment. Mindfulness based therapy offers a natural, calming approach to wellness and helps to center people in a way that promotes harmony. Mindfulness usually is combined with CBT and exposure therapy.
Some children with severe cases of OCD benefit from various types of medications. These medications help to soften anxieties and worries. Clinically speaking, we are talking about the following types of medications:
Other medications are sometimes used as well and will depend upon the child’s medical history and presenting symptoms.
Treating OCD in Children
Disrupts Irrational Thoughts
Reduces Fear & Anxiety
Offers New Thoughts
Effective with CBT
OCD in Children Video
Summing Things Up
One of the most difficult challenges facing parents and clinicians working with an OCD child is the extreme shame the youngster has around their behaviors.
This is why it is vital that parents not judge children who have obsessions or make any shaming type statements (i.e. Stop acting crazy!).
Know that your child was born with OCD and that it is not your fault. Obsessive Compulsive Disorder is a legitimate medical issue that is more common than you might think.
If you want to learn more about OCD, I encourage you to pick up a copy of the book suggested in this article and visit the anxiety related websites listed on the side bar.
Young people with this anxiety based disorder can successfully learn to manage their thoughts and control symptoms. This will require patience on your part, combined with compassion and love.
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Larry Rankin from Oklahoma on June 13, 2015:
Like with most disorders, it is also a matter of severity of symptoms.