What is OCD and How Can You Spot OCD in Children?

OCD stands for Obsessive Compulsive Disorder, which is a type of anxiety disorder, causing the person to obsess over small things and compulsively perform certain rituals. The person struggling with OCD can feel compelled to carry out specific behaviours or rituals, having constant thoughts about them, even when they try really hard not to.

OCD can be caused by a variety of factors such as genetics, specific brain chemistry, environmental factors and the symptoms can be exasperated by an increase in stress, anxiety or challenging, traumatic circumstances.

The obsessive nature of this disorder is very much driven by the primitive part of our brain – whose primary concern is to keep us safe. OCD creates both fear and doubt and means that the person may at times seem to manage their compulsion in the moment (especially if they are working to cope in a social setting) but will then need to continually recall the events and doubt that they took the required action to keep themselves, or others, safe.

The Science Behind OCD in Children: More about the brain…

If there is a danger in front of us (we use the example of a polar bear with children) then our fight or flight would kick in. Remember the role of the primitive brain is to keep us safe. The primitive responses are anxiety (causing us to run away), anger (which prepares us to fight) or, alternatively, we stay in our safe place and avoid the danger entirely (freeze).

This part of the brain isn’t rational or optimistic like our intellectual mind – it doesn’t have time to stop and think about a detailed, logical exit strategy or calmly assess to what extent the thing in front of us is actually dangerous.  This part of the brain will:

  • Deliberately make you focus on how awful the outcome could be!
  • Be super obsessional – making you think about it over and over and over and over again!

Both are great responses if there’s a real danger and we need to escape pretty sharpish or keep a vigilant eye out for the polar bear – not so great though if the danger is perceived rather than a reality and you’re just trying to get on with your day.

So, if there is no immediate danger or ‘polar bear’ why does the brain encourage people suffering with OCD to continue to display ‘survival’ behaviours even though they are actually safe?

The Youth Fairy Analogy – The Stress Bucket…

We use the metaphor of a stress bucket with the children we work with – the more stress, negativity, pressures etc they have building up in their lives, the more their bucket is filling up and their level of intellectual, rational control is lessened.

More in stress bucket = more time in their primitive mind = feeling more anxious, angry or miserable = behaving in ways that reflect this.

There are different ways OCD can manifest (more on that later) and carrying out certain rituals obsessively is one of them.

This might involve:

  • Excessive handwashing
  • Excessive cleaning
  • Touching rituals such as tapping an object a certain number of times
  • Checking rituals for example if a tap has been turned off
  • Repeating certain words or phrases
  • Repetitive questioning

Often the person struggling with OCD is aware that their thoughts, actions and compulsions are irrational, but they are driven by doubt and fear of the outcome and are unable to avoid the compulsion due to the level of anxiety which is then created.

The person feels, often subconsciously, that by doing these they are keeping the polar bear away. It’s not uncommon for the person to start to believe that not doing the ritual will result in something bad happening to them or a loved one.

Children with OCD: Why repetitive thoughts or behaviours?

Another way our primitive mind helps us survive potentially life-threatening situations is by storing previous responses or reactions that have helped us stay safe in the past. This can be helpful if we are faced with danger – we have a tried and tested way of escaping! However, if there is no ‘real’ danger and our child is struggling with the build-up of stress and anxiety in their lives then the primitive mind is going to get them repeating those ritualistic behaviours – they become their go to coping strategy.

Obsessive Compulsive Disorder in Children: They then get stuck in a vicious cycle! 

They feel more negative and miserable about behaving in this way = build up more stress = longer in their primitive mind = more intrusive thoughts, fears and repetitive behaviours.

OCD doesn’t always manifest itself as compulsions though – it can also present as anger, anxiety, panic attacks and phobic avoidance of situations related to their fears such as dirt or contamination.

One of the challenges that people with OCD face is the need to fight both the stigma of mental health disorders and the widely held belief that OCD is a mild or even “quirky” problem that is nothing more than hand washing. Many people now use the term “a bit OCD” to describe an individual who is particularly ordered or organised, without understanding the debilitating nature of this disorder.

Different Types of OCD in Children

There are many different types of OCD; the most common being where the sufferer has intrusive thoughts about different things and obsesses over them.

OCD with Contamination

  • Fear that they will get sick from touching something “dirty” or will come in contact with germs.
  • May also obsess over becoming ill and start to avoid certain things to prevent them from getting sick.

OCD with Obsessions about Physical Symptoms

  • May obsess over the fact that they may be having a heart attack or some other illness.
  • Have intrusive thoughts about a serious illness and think they need to go to the hospital.

OCD with Obsessions about having Contaminated Thoughts

  • Obsess over their own thoughts being contaminated – they may have done something bad or immoral and obsesses over those thoughts.

OCD with Obsessions about Needing to do Rituals

  • Compulsions about needing to do rituals and obsess about their OCD causing harm to themselves or others.
  • This might present in the way of “checking” and may believe they have forgotten to do something important.
  • They may seek out that “just right” feeling, where everything has to be done in a special order or particular way or they may get extremely anxious.

OCD with Obsessions about Perfection

  • Obsessions about perfection, being perfect and making up for mistakes they think they have made.

OCD with Obsessions that Cause Anxiety

  • Obsess over things that they are afraid of.
  • Can also be “harm OCD” where the person has intrusive thoughts of harming themselves or others and obsesses over avoiding situations that they fear would result in them acting on OCD thoughts.

Hoarding OCD

  • It’s normal for children to want to keep things or forget to throw stuff away – we’ve all walked into our kids room and wondered where to start with the clean up!  But with OCD they might become very upset about having things moved or thrown away – things that seem to have no obvious specific value, for example, there could be an overly stressful response to having items you might consider rubbish thrown out.

If you are concerned about your child…

and think they display OCD type behaviours then you can:

  • Make an appointment with your GP in the first instance.
  • They may refer you to CAMHS or a specialist for an assessment.

You might also be considering seeking private therapy for your child, in which case feel free to contact your local Youth Fairy to book a free initial consultation, where we can explain (in a child friendly way) how OCD is created in the brain, why it’s causing your child to feel or behave in these unhelpful ways and how we work to help.

OCD also has an impact on families and friends, it draws in loved ones who can find themselves unsure as to how to help and whether they should support or challenge the OCD behaviours. OCD rituals can be very demanding on the whole family, affecting the relationships between siblings and parents.

How Our Solution Focused Therapy Works At The Youth Fairy

Our solution focused approach to working with OCD means that your child won’t have to spend a lot of time focusing on past problems or trauma or excessively talking about the behaviours themselves.

We take a holistic approach to working with OCD – we don’t focus on one particular behaviour and pop a ‘sticking plaster’ over it as it could potentially just spring a leak somewhere else in the stress bucket.

We focus on emptying their stress bucket in the first place:

  • Reducing the anxiety/stress in their lives – increasing the neurotransmitters that help them feel happier and calmer.
  • Taking positive steps to process, change or cope better with the things in their lives that are causing the stress and anxiety.
  • Help them engage in more positive interactions with others.
  • Identify and engage in new, better ways of reacting or behaving in the situations that they have been struggling with.

First and foremost, we work on helping them to get their lives in a really good place, however that looks for them. As their stress bucket comes down and they are operating more from their intellectual mind (think rational, calmer, optimistic, proper assessments) – they’ll feel much more in control of their emotions and lives – and, in turn, stop seeing so many polar bears, have a calmer, quieter mind and not feel the compulsive need to behave as if they are surrounded by danger all the time. 

Additional Information

OCD Action UK https://ocdaction.org.uk/

OCD UK – Free guide for young people written by OCD UK Young Ambassadors https://www.ocduk.org/teens/