OCD: Do Anxious Thoughts Trouble Your Child?

Help for obsessive-compulsive disorder in kids

It’s one thing when kids have anxious thoughts but cope with them fairly well. It’s another when those thoughts trigger behaviors that interfere with kids’ everyday lives.

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What are the signs of obsessive-compulsive disorder (OCD) in kids, and when should you seek professional help? Here, child psychologist Kate Eshleman, PsyD, answers questions that parents often ask:

What happens when kids have OCD?

OCD is an anxiety disorder that leads to an endless cycle of repetitive thoughts and behaviors that you can’t control.

“If you have OCD, you tend to either have obsessive thoughts, or intrusive and distressing thoughts that pop into your brain,” Dr. Eshleman says. The anxiety this creates can stimulate a need to perform repetitive behaviors or routines that make the unwelcome thoughts go away.

“For example, kids may think they need to wash their hands repeatedly or they will get sick. Or they can’t eat mom’s cooking because they will throw up,” she says. “This then leads to behaviors such as compulsive hand-washing or avoiding meals.”

While trying to ignore the repetitive behaviors will increase your child’s anxiety, it ultimately becomes the goal of treatment, she says.

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What are the warning signs of OCD?

Parents can judge whether or not to worry about OCD by watching how their child copes with their symptoms, Dr. Eshleman says.

“The two things to keep in mind are whether the symptoms impair your child’s functioning in any way, and whether they are bothersome to your child,” she says. Red flags to watch for include:

  • An increase or decrease in appetite
  • An increase or decrease in sleep
  • A change in mood (more irritable, angry or upset than usual)
  • Trouble concentrating or enjoying activities
  • Spending too long on daily tasks like getting ready for school
  • Difficulty making choices or decisions

If you notice any of these signs, talk to your child’s pediatrician, Dr. Eshleman advises. Pediatricians can recognize the signs of OCD and connect you with health professionals who know how to diagnose and treat it.

“Some children can deal with their OCD appropriately so that it does not interfere with their day-to-day functioning,” she says. “But, for other children, it is upsetting. Speaking to your physician will help your child get treatment that can bring relief.

How is OCD treated in children?

One misconception about OCD is that you can’t do anything about it — untrue, says Dr. Eshleman. “This is a treatable diagnosis,” she stresses. “Meeting with a psychologist or a therapist is your first step.”

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Treatment for OCD involves therapy and, if necessary, medication:

  • Cognitive-behavior therapy (CBT). Best done by a psychologist, CBT is often the most effective treatment, she says. Through techniques like exposure and response prevention, CBT helps kids confront their anxiety without having to perform compulsive behaviors.
  • Medication. If therapy isn’t working, your doctor may consider selective serotonin reuptake inhibitors (SSRIs) such as Prozac® or Zoloft®. Research links low levels of serotonin to OCD, and these drug increase serotonin levels in the brain.

“The important thing to remember is that there are opportunities to help your child,” says Dr. Eshleman.

“If you have any concerns at all, meet with your pediatrician first. Your pediatrician can refer you to a psychologist or therapist who can help your child become happy, healthy and functioning as he or she should.”

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