Written by Regine Galanti
In both adults and children, OCD is characterized by two core symptoms: (1) repetitive, distressing thoughts (obsessions), and (2) repetitive/difficult-to-resist behaviors aimed at getting rid of one’s thoughts (compulsions). Similarly, for both adults and children these symptoms tend to take up significant time/energy, interfere with one’s daily schedule, and cause distress. However, when adults have OCD they tend to recognize that their symptoms are a psychological disorder. When children have OCD, recognition of the problem is much more difficult. For example – children with OCD may not be able to identify any obsessions – they may simply say that they feel the need to engage in a behavior “until it feels right.” Additionally, children tend to hide their symptoms out of shame, fear or other reasons. Furthermore, sometimes children with OCD simply come across as quirky or eccentric though inside they are consumed with fear. Other times, they may act out aggressively if they can’t fully perform their compulsions. Because of these factors, parents of children with OCD often attribute OCD behavior to quirkiness or defiance, and they may be slow to recognize that their child has OCD.
Here are the facts: OCD in younger children tends to emerge around age 7-12 an symptoms tend to fluctuate in several ways. First, they tend to get better and worse over time – e.g., they may become severe during times of stress, and all but disappear when things are going well. Second, they may appear in some situations but not others – for example, many children will exhibit OCD at home but not school. Third, and most important, the content of a child’s obsessions or compulsions tends to change as the child grows. Children at this stage of development are starting school and moving from a more fantasy based understanding of the world to a more realistic one. This shift makes the symptoms all the more scary, lending to some children hiding their symptoms from their loved ones. As such, what we look for in diagnosing childhood OCD is a consistent pattern of worries and behaviors that take up more than an hour a day, cause noticeable distress, and/or interfere with everyday activities, over time. While OCD tends not to go away completely without treatment, there is very good news: If you do suspect that your child has OCD, trained clinicians can be helpful in diagnosing the problem, and behavior therapy is highly effective in treating it!
Are you a mental health practitioner interested in learning more about the treatment of childhood OCD? Sign up for our upcoming workshop given by Dr. Allen Weg on Sunday March 23rd here.