Helping Kids Cope with OCD

Armen Hareyan's picture

While it is natural for children to worry, sometimes these worries can take over a child's life, leading to severe levels of fear, anxiety and stress.

For some children and adolescents, this persistent anxiety can turn into an obsession, which a child may then try to relieve by performing certain behaviors repeatedly, which is known as a compulsion. More than one million children in the United States are diagnosed with this psychological condition, known as obsessive-compulsive disorder (OCD).

Just as in adults, OCD symptoms often appear in kids in such behaviors as prolonged hand-washing, repeated checking of locked doors and needing to have personal items neatly arranged in an exact, unchanging order.

Phoebe Moore, Ph.D., assistant clinical professor at the Duke Child and Family Studies Center, said OCD can make life highly stressful for a child.

"We've all had the child who needs a bedtime story read three times in a row," she said. "Usually that's normal. It's when it starts causing distress, when if you don't read the story three times in a row, there's a huge meltdown.

"They might wash their hands until their hands are raw," she continued. "Long stints in the bathroom are very common in OCD kids. Checking again and again to make sure doors are locked. There are prayer rituals, when the child has to say a special prayer a certain number of times. And making things even, like if you touch the left side you have to touch the right side.


"The key always with childhood mental illness or disorders of thought or feeling is impairment," Moore said. "School grades begin falling or getting to school becomes more difficult. A child has less interest in friends. Family relationships are affected, there are problems at home, you can't get the chores done, can't get the table set for dinner because you're too busy washing in the bathroom. OCD starts to really interfere with the quality of life."

Moore has seen parents become frustrated and angry at a child with OCD, believing the child should simply "turn off" the obsessions and cease the constant repetitive behaviors. But she said getting angry may only make the condition more difficult to control.

"One of the hallmarks of OCD is that it is irrational," she explained. "We all know that you don't have to wash your hands for two hours to get rid of the germs, but OCD is telling the kid, 'Yes, I do need to wash that much.' So parents get very upset and may exhort the child to stop or even physically prevent the child from ritualizing. This makes things more frightening for the child. It can make rituals more likely to happen or stronger because the anxiety level has gone up.

"We think the number-one thing to do if you have a child with OCD is to find a therapist who is trained in CBT, or cognitive behavior therapy, for obsessive-compulsive disorder," Moore said. "It's a really effective treatment and teamed with medication, it's even better."


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