Could my Child Have Obsessive-Compulsive Disorder?

A boy washing his hands.

All of us experience anxiety that can cause us to behave obsessively from time-to-time, such as when we change clothes six times before a job interview or pack and repack before a big vacation. But for kids and teens who struggle with Obsessive-Compulsive Disorder, these sorts of rituals are more than a fleeting indulgence. They can feel like necessary behaviors that must be performed correctly to prevent catastrophe. OCD in children can manifest itself in a variety of ways, making it important to recognize the signs of OCD in children.

For parents, it can be challenging to spot in their children the line between personality quirks and the compulsive behaviors of true Obsessive-Compulsive Disorder (OCD). This is because many kids lack both the insight to articulate their thoughts and anxieties and the perspective to realize their anxieties might not match up with reality.
As a result, parents often only have behaviors as a clue. Here are some common OCD symptoms in children that prompt parents to wonder if their child might have OCD:

  • Excessive and persistent worries or fears.

  • Repeated and frequent hand washing, cleaning, or other checking behaviors.

  • Difficulty in controlling unwanted thoughts or images.

  • Repeating certain words or phrases out of context.

  • Needing to share thoughts or recent events in a ritual way that includes a parent responding with specific phrasing as well.

  • Ritualized behaviors or routines that are time-consuming and interfere with daily activities.

  • Avoidance of situations that have triggered compulsive behaviors in the past.

  • Emotional distress when compulsive behaviors are prevented or interrupted.

What should I do if I think my child has OCD?

Talk with your Pediatrician about your concerns. He or she can refer you to the appropriate mental health specialist for evaluation. There are many therapies and even medications to help manage Obsessive-Compulsive Disorder, but all treatments begin with evaluation and diagnosis.

If my child is diagnosed with pediatric OCD are they ever going to live a normal life?

This is a common parental fear, but take heart. The severity and persistence of OCD symptoms in kids vary from child to child, and there are several factors that can influence whether a child will outgrow the disorder. For example, the type and severity of symptoms, the child’s age at onset, and the presence of other mental health conditions or family history can all affect the course of the disorder.

For many kids, intervention with effective treatments such as cognitive-behavioral therapy (CBT), Dialectical Behavioral therapy (DBT), and medication can help reduce the severity and duration of OCD symptoms, increasing the likelihood of a good outcome.

With appropriate treatment and support, many children with OCD can manage their symptoms and lead fulfilling lives.

Does an OCD diagnosis mean my child will have to be medicated?

There are medications that can be prescribed for children with OCD, but diagnosis is not synonymous with medication therapy.

The most commonly prescribed medications for OCD in children and adolescents are selective serotonin reuptake inhibitors (SSRIs). These SSRIs are a type of antidepressant that can help reduce the symptoms of OCD by increasing the level of serotonin in the brain.

However, SSRIs can have side effects, such as nausea, stomach upset, headaches, and insomnia. As a parent, you’ll want to discuss medication’s potential risks and benefits with your child’s Pediatric team. If you decide to try medication, you’ll need to follow the instructions and closely monitor your child’s response.

For some kids and teens, a combination of medication and psychotherapy may be the best route to help manage OCD. For others, therapy alone can offer enough tools to help a child manage their condition with support at home.

Whichever path treatment takes, parents should expect to work closely with their child’s medical and mental health providers to determine the best treatment plan for their child’s individual needs—and monitor its progress.

What are the non-drug options for managing my child’s OCD?

There are several non-drug interventions to help a child with OCD. Some are therapies offered by a licensed therapist, and others are techniques that can be learned and practiced at home with parents:

  • Cognitive-behavioral therapy (CBT): CBT can help children and teenagers learn to identify and challenge their negative thoughts and beliefs that drive their compulsive behaviors.

  • Dialectical Behavioral Therapy (DBT): DBT focuses on teaching emotional management skills needed for children and teens that experience their emotions intensely.

  • Exposure and Response Prevention (ERP): ERP is a type of CBT that involves gradually exposing the patient to feared situations or objects and teaching them to resist the urge to perform compulsive behaviors.

  • Occupational therapy: Occupational therapy can help children with OCD learn skills to manage their symptoms, such as time management, organization, and self-regulation.

  • Mindfulness-based interventions: Mindfulness techniques such as meditation, breathing exercises, and visualization can help children with OCD learn to cope with their symptoms by increasing their awareness of their thoughts and emotions.

  • Relaxation techniques: Relaxation techniques such as deep breathing, progressive muscle relaxation, or yoga can help children and teens with OCD manage their anxiety and stress.

What causes Obsessive-Compulsive Disorder in Kids?

The exact causes of OCD are not fully understood, but it is believed to be a combination of genetic, neurological, and environmental factors. Research suggests that individuals with OCD may have differences in brain structure and function, particularly in areas related to decision-making and fear processing. Additionally, stressful or traumatic life events, such as abuse or illness, may trigger the onset of OCD in some individuals. A family history of OCD may also increase the risk of developing the disorder.

Candace Basile, LCSW

Candace Basile, LCSW

Candace is a therapist in our South Jordan Counseling office.

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