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Obsessive Compulsive Disorder (OCD)

1. What is OCD?

OCD is an anxiety (worry) disorder, which consists ofobsessions and compulsions.

Obsessions are intrusive, repetitive and unwanted thoughtsthat your child may experience, usually accompanied byhigh levels of anxiety, guilt and a sense of responsibility.

Compulsions, sometimes called rituals, are the things yourchild does to reduce the anxiety or guilt caused by theobsessional thoughts. Some compulsions will be obviousto you, others may not.

2. Whatare the symptoms of OCD in children?

  • Obsession – where an unwanted, intrusive and often distressing thought, image or urge repeatedly enters your mind.
  • Anxiety – the obsession provokes a feeling of intense anxiety or distress.
  • Compulsion – repetitive behaviours or mental acts that you feel driven to perform as a result of the anxiety and distress caused by the obsession.
  • Temporary relief – the compulsive behaviour temporarily relieves the anxiety, but the obsession and anxiety soon returns, causing the cycle to begin again.
  • It’s possible to just have obsessive thoughts or just have compulsions, but most people with OCD will experience both.

Parents may notice other difficulties that can be a result of OCD. For example, OCD can cause children to:

  • have trouble concentrating on schoolwork, or enjoying activities
  • feel and act irritable, upset, sad, or anxious
  • seem unsure of whether things are OK
  • have trouble deciding or choosing
  • take much too long to do everyday tasks, like getting dressed, organizing a backpack, completing homework, or taking a shower
  • get upset and lose their temper if they can’t make something perfect or if something is out of place
  • insist that a parent say or do something an exact way
    Children with OCD feel unable to stop focusing on their obsessions. They feel like they have to do the rituals to guard against bad things they worry could happen. For some children, doing a ritual is the only way they feel “everything’s OK.”

3. What can cause OCD in children?

At the moment, no one knows exactly what causes OCD, butthere are some factors that research has shown can possiblymake children more vulnerable to OCD. It is thought that somechildren are genetically more likely to be anxious, somechildren’s temperament mean that they are more likely todevelop anxiety related disorders, and OCD is sometimestriggered by an event that a child may perceive as frightening.

Developmental life events such as staying overnight away fromhome for the first time, exams, bullying, health problems, changein family circumstances and bereavement may also be linked to theonset or worsening of OCD symptoms.The majority of children will have real understandable anxietyin such circumstances, but if a child is vulnerable to developingOCD, these things can act as a trigger.

4. What are the treatment modalities at LWHCC for OCD?

OCD is treated with medicine and therapy. For children who need medicines, our psychiatristswill carry out an assessment to discuss on the right medication and collaboration with psychologists.

Therapists treat OCD with cognitive behavioral therapy. During this kind of talk-and-do therapy, children learn about OCD and begin to understand it better. They learn that doing rituals keeps OCD going strong, and that not doing rituals helps to weaken OCD. They learn ways to face fears, cope with them, and resist doing rituals. Learning these skills helps stop the cycle of OCD.Part of treatment is coaching parents on how they can help children get better. Parents learn how to respond to OCD situations, and how to support their child’s progress without giving in to rituals.

5. Which treatment modality is better for me?

The most important thing about treatment is to start it as soon as possible after diagnosis, because delaying this makes OCD more difficult to treat.

Psychological treatment such as Cognitive Behavioural Therapy (CBT) as the first line of treatment for OCD in young people. Medication should be a secondary option and given alongside CBT.

6. What can you do to help your child?

Caring for children with OCD can be extremely hard, stressful and draining experience, which is difficult to share with others. Often a child’s obsessions and compulsions dominate family life, which in turn can create tension between family members. Still, you can support yourself and your child by following some of the tips below:

  • Talk supportively, listen, and show love. Say something that works for your child’s situation like, “I notice you worry about your covers being smooth, your socks being even, and your shoes lined up. I notice it gets you stressed if you can’t fix things just so.”
  • Say that something called OCD might be causing the worry and the fixing. Tell your child that a checkup with a doctor can find out if this is what’s going on. Reassure your child that this can get better, and that you want to help.
  • Make an appointment with a child psychiatrist or psychologist.
  • Take part in your child’s therapy. Learn all you can about how parents can help when their child has OCD. Overcoming OCD is a process. There will be many therapy appointments, and it’s important to go to them all. Practice the things the therapist recommends. Encourage your child.
  • Get support, and give it.

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