Unstuck: Escaping OCD's Grip
For children with obsessive-compulsive disorder, early diagnosis and treatment are essential. Strategies to get their minds “unstuck” on the things they obsess about can help kids with OCD lead å positive, productive lives. Although most often a psychological disorder, some forms of OCD can be caused by viruses, including streptococcal, and can be treated with antibiotics.
OCD can be diagnosed as young as age 7 or 8, but unfortunately, children with the disorder sometimes receive a different, incorrect diagnosis.
For example, “they are misdiagnosed as having an autism spectrum disorder because of their rigid, inflex-ible behavior, and when you are obsessing in your thoughts, you are not socially relating to people,” says Douglas Tynan, PhD, program director at Nemours Health and Prevention Services in Newark, DE.
The diagnosis of OCD can be tricky, adds Katherine Dahlsgaard, PhD, lead psychologist for the Anxiety Behaviors Clinic (ABC) at The Children’s Hospital of Philadelphia. “Parents should seek out a specialist in anxiety disorders because if it is OCD, a good diagnosis guides treatment. The good news is that Philadelphia is a mecca for specialists in anxiety.”
OCD behaviors such as hand washing or hoarding are more easily treated than internalized obsessions such as counting or needing to repeat specific phrases. Without treatment, an obsession can completely overtake the child. A child with a fear of germs or dirt might panic and be unable to use a restroom in school, for instance.
“The most effective treatment is a combination of anti-depressant medication and cognitive therapies to teach children to challenge irrational beliefs and cope with them,” says Dr. Tynan. ERP (exposure and response prevention) therapy teaches children how to neutralize the stress and anxiety caused by thoughts that lead to compulsive rituals. “The classic example is the child who has a fear of contamination,” explains Dr. Dahlsgaard. “If I touch that door handle I will get germs all over me and then I’ll get really sick and I’m going to die.”
A therapist works with the child to gradually touch the doorknob, recognize that his anxiety will temporarily increase, but understand that in the long term he will overcome that anxiety.
Causes of OCD
Most often, OCD is genetic. Family members often have the same obsessions or compulsions. For example, if you have a relative who is a compulsive hand washer, look for signs of that behavior in your child.
New research has found that otherwise healthy children can develop OCD due to strep or other types of infection. “Your kid goes to bed, normal kid, no problem, and the next morning wakes up with severe OCD — with ticks or separation anxiety,” explains Dr. Dahlsgaard. Once treated with an antibiotic, the OCD symptoms usually disappear if they are caused by a virus.
Once they learn how to manage their behaviors, kids with OCD can lead normal lives. “It’s pretty common in high achievers and I think people with OCD tend to go into careers that require a high degree of precision,” says Dr. Tynan. “They can be very successful and satisfied.”
Terri Akman is a contributing writer to MetroKids.