Does my child have Obsessive Compulsive Disorder?
Are you concerned your child may have OCD? Here are a few signs and symptoms of this common mental disorder characterised by obsessions and compulsions.
While anxiety is a normal reaction to uncertainty and change, a child who is over anxious when it comes to rituals and routines may have a common mental condition known as Obsessive Compulsive Disorder, or CD for short.
What is Obsessive Compulsive Disorder (OCD)?
OCD is a common mental disorder characterised by obsessions and compulsions. Obsessions are intrusive unwanted recurring thoughts, urges, or images. It can range from the fear of contamination, fear of causing harm, fear of dying, ridged thinking, and the fear of things not being in order. Thoughts about contamination might be even more concentrated during this time and children may respond to these fears by obsessively washing their hands, avoiding people or situations, and religiously wearing gloves or a mask. These actions are known as compulsions. Compulsions involve repeatedly performing purposeful and meaningful actions in a very rigid and structured routine, specifically in relation to obsessional thoughts. Children may believe that engaging in these compulsions will somehow prevent bad things from happening.
OCD compulsions
A few OCD compulsions or urges may include:
- Frequent confessing or apologising
- Saying lucky words or numbers
- Excessive checking and re-checking
- Excessive washing and/or cleaning
- Repeating actions until they are “just right”
- Repeatedly ordering or arranging things.
- Mental actions like excessive praying, mental reviewing, or counting.
Preoccupations or obsessions are hard to identify in young children as they may not be able to articulate the reasons for their repetitive behaviours or thoughts. In contrast, compulsions are quite plain to see. Boys are more affected by OCD in childhood and have an earlier onset than girls.
Rapid Change in behaviour and mood
In very rare cases, symptoms may develop suddenly with a rapid change in behaviour and mood and the abrupt appearance of severe anxiety. If this is the case, it is that the child has a sub-type of paediatric OCD caused by an infection such as strep throat. Strep throat is a bacterial infection that is characterised by a sore and scratchy throat. This infection can confuse the child’s immune system into attacking the brain instead of the infection. When this happens, the child begins having severe symptoms of OCD, often seemingly all at once, in contrast to the gradual onset seen in most cases of paediatric OCD. This rare type of OCD due to a strep infection is called Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS). If it’s caused by another infection, it’s called Paediatric Acute-Onset Neuropsychiatric Syndrome (PANS).
How to treat OCD
Overall OCD is treatable, but overcoming it isn’t a quick or easy process. Children diagnosed with OCD usually need to work with a therapist and take medicines to help manage their behaviours and the accompanying thoughts and feelings. However, parents are invaluable in supporting their children during this pandemic. One way you can help your child diagnosed with OCD is to stay informed. Knowing the facts surrounding Covid-19 can help reduce stress. If your child is frightened of getting sick, you can remind them that people are staying home to prevent the spread of Covid-19. By reframing the situation, you can bring more certainty to an uncertain situation.
The importance of routine
Similarly, you can create more structure and predictability at home by establishing a daily routine. Write out a plan for each day and notify your children of the plan. Ideally, you need to keep their routine as close as possible to what it was before COVID-19. Have your children wake up, get dressed and eat breakfast at the same time they would for school to help create a sense of “normality”. Use the school schedule as a template but switch activities every 30-40 minutes or so. At “lunchtime”, eat lunch together. Also, try to encourage healthy eating during the day as it helps manage their energy levels. They should also be getting enough sleep and engage in physical exercise. You may want to think about the types of activities that helped relax your child when they experienced other stressful events in the past. Activities that soothe and promote self-care should be at the heart of the daily routine.
Helping a child with OCD
If you suspect that your child may have OCD or is presenting with OCD symptoms, reach out to a health care professional. You can consult your general practitioner during the lockdown period and request a referral to a psychiatrist or specialist paediatrician. In addition, you can contact a psychologist in your area to set up an online consultation during the lockdown or an in-person consultation for after the lockdown.
