OCD In Children
What Is Life Like For Children Who Have OCD?
OCD can make daily life very difficult and stressful for children. OCD symptoms often take up a great deal of a child's time and energy, making it difficult to timely complete tasks such as homework or household chores. Children may worry that they are "crazy" because they are aware their thinking is different than that of their friends and family. A child's self-esteem can be negatively affected because the OCD has led to embarrassment time and time again, or has made the child feel "bizarre" or "out of control."
Mornings And Evenings Can
Be Especially Difficult For
Children With OCD:
In the morning, they often feel they must do their rituals exactly right, or the rest of the day will not go well. Meanwhile, they are feeling rushed to be on time for school. This combination leads to feeling pressured, stressed, and irritable. In the evenings, they may feel compelled to finish all of their compulsive rituals before they can go to bed. At the same time, they know they must get their homework done and take care of any household chores and responsibilities. Some children stay up late into the night because of their OCD, and are then exhausted the following day.
Children with OCD frequently don't feel well physically. This may be due to the general stress of having the disorder, or it may be related to poor nutrition or the loss of sleep. In addition, obsessions and compulsions related to food are common, and these can lead to irregular or "quirky" eating habits. Because of these and other factors, many children with OCD are prone to stress-related ailments such as headache, or an upset stomach.
Children with OCD sometimes have episodes in which they are extremely angry with their parents. This is usually because the parents have become unwilling (or are unable!) to comply with the child's OCD-related demands. For example, children with obsessions about germs may insist that they be allowed to shower for hours, or demand that their clothes be washed numerous times or a particular way. Even when parents set reasonable limits, children with OCD can become excessively anxious and angry. However, this anger does not justify physical or verbal abuse between parent and child. If violence or abuse is occurring within the home, it should not be tolerated, and seeking professional help may be necessary.
Friendships and peer relationships are often stressful for those with OCD because they typically try very hard to conceal their rituals from peers.
When the disorder is severe, this becomes impossible, and the child may get teased or ridiculed. Even when the OCD is not severe, it can affect friendships because of the amount of time spent preoccupied with obsessions and compulsions, or because friends react negatively to unusual OCD-related behaviors.
OCD and Other Psychiatric Disorders Children with OCD appear more likely to have additional psychiatric problems than those who do not have the disorder. Having two (or more) separate psychiatric diagnoses at the same time is called comorbidity. Below is a list of psychiatric conditions that frequently occur along with OCD:
Additional anxiety disorders (such as panic disorder or social phobia)
Disruptive behavior disorders (such as oppositional defiant disorder, or attention-deficit hyperactivity disorder)
Tic disorders/Tourette's syndrome
Trichotillomania (hair pulling)
Body dysmorphic disorder (imagined ugliness) Sometimes comorbid disorders can be treated with the same medication prescribed to treat the OCD. Depression, additional anxiety disorders, and trichotillomania may improve when a child takes anti-OCD medication.
On the other hand, ADHD, tic disorders, and disruptive behavior disorders usually require additional treatments, including medications that are not specific to OCD. A booklet of this size cannot fully address all the possible comorbid conditions a child with OCD could have, nor all the possible medication approaches used for these comorbid disorders.
However, in general, using the smallest amount of medication effective in controlling symptoms, and starting low and going slow in regard to drug dosing are common sense approaches. In unusually complicated situations, or in situations where the OCD appears resistant to drug treatment, a consultation with an expert in the area of childhood OCD is warranted.