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Obsessive Compulsive Disorder (OCD) in Children and Adolescents

What is OCD?

Obsessive Compulsive Disorder can be debilitating and frustrating for children and teens. It is defined by obsessions and compulsions that are time consuming and cause distress or impaired functioning.

Obsessions are the thoughts that go around and around in the mind, almost as if there is a glitch and they get stuck on repeat. Despite efforts to get rid of them they remain and cause your child/teen to feel bad.

Compulsions are the behaviours your child/teen does in an attempt to get rid of the negative thoughts (Obsessions) and feelings. For example a child may wash their hands over and over not because they want to, but because they feel they have to. These compulsions become rituals that are done the same way every time.

Example:

Obsessive Thought – “What if I have germs on my hands?” “What if I get sick?” “What if I get so sick that I end up in hospital?”

Compulsion – repeatedly wash your hands to eliminate germs.

The problem with OCD is that it wants more: the more your child/teen washes their hands, the more the obsessive thought is reinforced and grows and so the more hand washing is required.

OCD is like a hiccup in the brain.

How do we treat it?

It is important to take a gradual approach with children and teens. Firstly we need to consider the flight/fight response of humans in relation to OCD. Every time your child or teen gets an obsessive thought, they take the ‘flight’ response (i.e. they escape the feared thoughts by washing their hands) in order to make the uncomfortable feelings go away. The problem is they only go away temporarily. By taking the ‘flight’ option they don’t allow themselves the opportunity to adjust to the uncomfortable feelings, or use coping strategies or give the anxiety time to peak and then lessen. When it comes to fear (e.g. fear of heights, germs etc.) we know that if we stay in the feared situation long enough the associated anxiety will taper off.

So, this is the approach we take with children and teens in order to reduce the OCD and manage the negative feelings. For example, we set small and gradual goals of only washing their hands twice instead of three times and once their distress reduces to an agreed acceptable point, then we move on to the next goal (e.g. washing their hands only once).

In order to cope with the associated distress, we firstly equip them with a tool kit of coping strategies. These include: Deep Breathing, Mindfulness, Grounding, Progressive Muscle Relaxation, Visualisation, managing obsessive thoughts etc. Once they have learnt these strategies we then begin the goal setting explained above.

For more information on Obsessive Compulsive Disorder and treatment please make an appointment with Leia.

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