Warning signs a child may be suffering from OCD
At our clinic, we often have young people present after years of suffering without receiving a correct diagnosis, even after seeing multiple mental health professionals. Unfortunately, it can be difficult to differentiate OCD from other anxiety disorders, particularly when children are reluctant or embarrassed to discuss their obsessive thoughts. If you are unsure if your child is experiencing OCD, here we outline some of the key warning signs for this secretive problem.
The worries are a bit bizarre. Children with anxiety disorders such as generalised anxiety will worry about things that are unlikely to, but can, occur such as parental divorce, failing an exam, extreme weather events, and health problems. What differentiates OCD from generalised anxiety is that the worries are pretty far-fetched, and can even be a bit weird. Kids and teens will often say before they disclose their OCD symptoms to us “This sounds so silly, but…” They will then go on to describe irrational fears such as worrying they can cause a car accident by not repeating something three times, or that they will become a paraplegic if they walk over a disabled car park. Children with OCD generally have good insight that their concerns are irrational, but they still get stuck in a painful loop of obsessions and compulsions.
Rational discussions don’t seem to help. Children with OCD can experience crippling doubt about the “what ifs” in life. Therefore, telling them their fears are unlikely to come true tends not to reduce their worries, because OCD will simply respond with: “Yeah, but what if it does happen? Do you really want to take that risk?” If providing your child lots of reassurance hasn’t really worked, or has even made the problem worse, this could be a sign they might be dealing with OCD.
They feel overly responsible. It’s pretty typical for a child with anxiety to worry about things that aren’t in their control. But young people with OCD often take that responsibility to an extreme. For example, they might be washing their hands excessively to prevent the spread of germs to other people or performing rituals to stop complete strangers from dying. For other children, their sense of responsibility might be associated with extreme guilt over having “bad” thoughts or for past behaviours.
They engage in compulsions. This one seems pretty obvious, as compulsive behaviours are a key symptom of OCD. Parents will often recognise OCD if their child starts to engage in repetitive actions such as hand washing, checking, or tapping and touching things. However, the compulsions in childhood OCD can often be hidden, as mental compulsions are extremely common. Mental compulsions include thinking certain words or phrases, such as replacing “bad” thoughts with “good thoughts”. Warning signs your child might be performing mental compulsions include: pausing mid-conversation appearing to be distracted by their thoughts, mumbling or muttering under their breath, and/or irritability when you interrupt their train of thought.
Compulsions are time consuming and cause distress. Parents often ask us “Is this an OCD thing?” when describing certain behaviours they notice in their child. Sometimes kids might seem “obsessed” with certain tasks, like playing with Lego or organising their room. If they enjoy the behaviour, it’s probably not OCD. If the behaviour is taking up a lot of time, is starting to interfere with their daily life, and is a cause of frustration because they just can’t get it “right”, it could be OCD.
While these symptoms can be worrying for parents and carers, the good news is that childhood OCD can be effectively treated using cognitive-behavioural therapy (CBT). If you are concerned about a loved one, contact us today to discuss assessment and treatment options.
Author: Cassie Lavell, Clinical Psychologist at Children’s Centre for Anxiety and OCD
