Children: curious, rambunctious, and innocent. As a child your mind is filled with strange thoughts: believing your parents are aliens, your pet can talk, or there are monsters in your closet. Additional to these thoughts, you probably had a few interesting habits: arranging your food by color, leaving your toys around your parent’s workspace, or avoiding cracks on the street. As you age, you grow out of these thoughts and quirks, reaching the conclusion they’re irrational. But what if you couldn’t? What if these thoughts of monsters felt so real that you couldn’t sleep? What if you wanted to step on that crack but you couldn’t because you were afraid it would make that monster angry? For children with obsessive-compulsive disorder, this may be their reality.
Obsessive-compulsive disorder (OCD) is described by the DSM-5 as the presence of time consuming and irrational obsessions and compulsions (American Psychiatric Association, 2013). Almost half a million children in the United States suffer from OCD. Approximately 25% of those with OCD developed it before age 14, with 25% of male cases occurring before the age of 10.
Unlike adults, children with OCD may not realize their obsessions and compulsions are excessive or view their symptoms as a disorder which can be treated. A result of their limited vocabulary, it may be difficult for them to communicate the purpose of their compulsions (Kulkarni and Sudarshan, 2015). Children are also more likely to involve other people, usually their parents, as part of their ritual; they have their parent confirm their obsessions and acts are logical or may request their family member’s assistance completing the ritual (American Psychiatric Association, 2013). Parents are confused by their child’s behavior and may perceive it as them being “bratty.” When they are unable to engage their parents in their ritual to dispel their worries, they can become anxious, withdrawn, irritable, or angry.
Routines and rituals are a part of everyday life for a child. They’ll say goodnight before sleeping, follow their class schedule, or eat lunch at a particular time. These repetitive acts help organize a child’s day and are considered normal. Following routines also help children socialize, develop hobbies, or generate stress management tools (Boileau, 2011). However, actions and thoughts stemming from OCD are time consuming and make daily life stressful for children. When in a school environment, children with OCD tend to find it difficult to make friends or take part in extracurriculars because of the amount of time consumed by their compulsions (Strauss, 2016). The Anxiety and Depression Association of America describes how OCD affects children academically:
“Students with OCD may appear to be daydreaming, distracted, disinterested, or even lazy. They may seem unfocused and unable to concentrate. But they are really very busy focusing on their nagging urges or confusing, stressful, and sometimes terrifying OCD thoughts and images. They may also be focused on completing rituals, either overtly or covertly, to relieve their distress.”
Early detection of OCD is crucial to recovery. There are various treatment options available for those with OCD, including support groups and therapy. The International OCD Foundation and the Anxiety and Depression Association of America provide resources, such as help finding the nearest therapy group, opportunities to be involved in the foundation and spread awareness of OCD, and information for family members to educate themselves.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Boileau, B. (2011). A review of obsessive-compulsive disorder in children and adolescents. Dialogues in Clinical Neuroscience, 13(4), 401–411.
Dotson, A. (2016, November 03). Tuesday Q&A: Ethan S. Smith. Retrieved February 26, 2017, from https://alisondotson.com/2015/07/28/tuesday-qa-ethan-s-smith/
Kulkarni, H., & Sudarshan, C. Y. (2015). Obsessive Compulsive Disorder in a 4-Year-Old Child. Indian Journal of Psychological Medicine, 37(2), 230–232. http://doi.org/10.4103/0253-7176.155647
Strauss, V. (2016, October 11). What obsessive-compulsive disorder does to a young mind when it grows unchecked. https://www.washingtonpost.com/news/answer-sheet/wp/2016/10/11/what-obsessive-compulsive-disorder-does-to-a-young-mind-when-it-grows-unchecked/?utm_term=.6d509ef1833d