Unfortunately, many adults mistakenly think that Obsessive Compulsive Disorder in children and adolescents is a rare occurrence and consequently these children and adolescents are misdiagnosed with depression, ADHD, conduct disorder or other conditions. However, OCD with childhood onset affects about 1% of all children. Furthermore, recent literature suggests that approximately half of all adults with OCD experience clinical symptoms of the disorder during their childhood.
OCD is a type of anxiety disorder and kids with OCD become preoccupied with whether something could be harmful, dangerous, wrong, or dirty – or with thoughts that bad stuff could happen. These upsetting or scary thoughts or images, called obsessions keep popping into a person’s mind and are extremely hard to shake. In order to banish the scary thoughts, ward off something dreaded, or make extra sure that things are safe, clean or right in some way, people with OCD feel a strong urge to do certain things repeatedly which are called rituals or compulsions.
Now with children, they may have a difficult time explaining a reason for their compulsions and say they do them “just because”. But in actuality, by doing a compulsion/ritual, someone with OCD is trying to relieve anxiety. Most kids with OCD may realize that they really don’t have to repeat the behaviors over and over again, but this anxiety could be so great that they feel that this compulsion is “required” or “a must”. In addition to feeling frustrated or guilty about not being able to control their own thoughts, children with OCD may also suffer from low self-esteem or shame about what they’re thinking. They may have difficulties with attention and concentration because of the intrusive nature of the thoughts.
The symptoms of OCD at home are more intrusive than at school which can result in being stressful for the child and family. All the family members including the child may feel powerless to change rigid patterns of behavior. At school the symptoms might be significantly different. The children with OCD may be successful in suppressing symptoms at school while they may be unable to do so at home. Families often notice these symptoms and seek treatment once the symptoms have started affecting the performance at school.
Here lies the importance of a mental health professional in rightly assessing and diagnosing the child with OCD. The symptoms of OCD might vary and appear different at different times due to the growth of the child, because of which the clinician may need to see the child over time to establish the right diagnosis. Other conditions which may look like or may accompany OCD also need to be properly distinguished.
These conditions include eating disorders (anorexia nervosa), phobias etc. Further, young people are often ashamed and embarrassed about their symptoms and may not participate fully in giving information; therefore the clinicians would need to phrase question with great sensitivity and compassion to facilitate the sharing of information from the child’s side. Lastly children may be unaware or unwilling to admit that their behavior may indicate symptoms of a disorder. This proves to be the biggest challenge for a mental health professional while treating children/adolescents with OCD.
Usually psychotherapy proves to be sufficient in treating OCD in children and adolescents; however medicines may be prescribed by a child or adolescent psychiatrist if there seems to be no improvement after a significant period of time. Commonly used psychotherapies for treating OCD in children include Cognitive Behavior Therapy, parent guidance sessions, group psychotherapy, individual psychotherapy etc. EFT*( Emotion Freedom Technique) too has shown effective results. A holistically integrated approach will prove to be very effective for these children.
The symptoms need to be identified at the earliest and the child / adolescent provided with early intervention and supported towards healing and wellness.