As all parents know, kids can be particular about certain things. Maybe they wear the same shirt every day for a week, or insist on only eating certain foods. But those behaviors are mere quirks when compared with the stubborn, panic-stricken behaviors of children and teenagers with Obsessive-Compulsive Disorder (OCD).
MORE THAN JUST RINSE AND REPEAT
Take Cathy Wilson*, a mother of three young children, who noticed early on that her oldest child, Belinda*, had tantrums in response to any change in her routine. Fast-forward a couple years, and Belinda, almost 4, now insists on certain rituals.
“There is always an order she has to go in,” says Cathy. “For example, when I drop her off at school, she has to hug me three times and then kiss me three times. If I try to change it, like kiss her first before a hug, she goes into a panic.”
GETTING THE RIGHT DIAGNOSIS
Belinda’s pediatrician told Cathy that while it is too early to diagnose OCD, her daughter definitely exhibits OCD-related tendencies.
An anxiety disorder in which a person becomes consumed with fearful thoughts, OCD is certainly not something to take lightly. Moreover, diagnosing OCD in children is especially tricky.
“Clinicians who work with children have to be aware that there is a lot of overlap in these symptoms and some behaviors that occur normally in children,” says Peter Stavinoha, Ph.D., director of neuropsychology services at Children’s Medical Center of Dallas. “The real job of the clinician is to distinguish what’s normal from what may be representative of the disorder.”
DEALING WITH THE DAY TO DAY
Once a diagnosis of OCD is established, treatment options can include medications to break the cycle of anxiety, and psychotherapy to help alter the child’s thinking pattern.
Living with OCD can create a multitude of problems for a child or teenager. In addition to the toll it can take on a child’s home life, problems can arise at school and with peer relations. Obsessive thoughts may interfere with a child’s ability to concentrate on class work or their performance on tests. Peers may be confused by the child’s compulsive behaviors, which can result in loss of friendships. Severe compulsions can also cause the child to miss school entirely.
For parents of children with OCD, patience and understanding are critical. According to Dr. Stavinoha, parents need to understand that rituals, obsessions and compulsive behaviors are not logical.
LEAVE REASONING BEHIND
“The person is bothered by their own obsessions and their own compulsive behaviors,” he says. “And yet, it ends up being reinforced through the disorder by the ritual or the behavior—it’s almost like scratching an itch. Parents need to know that they can’t talk a child out of it by reasoning.” Not only is that ineffective, but also it can reinforce the behavior or make the child feel worse.
Cathy learned that lesson with Belinda. For now, she’s keeping an eye on any changes in her daughter’s behavior and remains practical about the situation.
“It makes life a little harder around here, but you learn to work with it.”
*names have been changed.